CLEAN MILK 



for 



NEW YORK CITY 




REPORT 

OF 

MILK CONFERENCE 

CALLED BY 

THE NEW YORK ASSOCIATION 
FOR IMPROVING THE 
CONDITION OF THE POOR 

105 EAST TWENTY-SECOND STREET 
848-349 GRAMERCY 



Opportunities for Benevolence 

How the Association for Improving the Condition of the 
Poor uses gifts and legacies is shown in its Annual Report, 
which will be mailed on request ; Junior Sea Breeze School 
for Mothers, and its campaign for clean milk, clean air and 
clean babies, prove the Association's knowledge of needs 
and its ability to organize and execute new work when funds 
are provided. We shall_ be glad to write to lawyers or to 
prospective givers statements of fact showing that the com- 
munity needs : 

Another Junior Sea Breeze ; 

Educational funds to tell the truth over and over again 
about the conditions that make children sick; 

Educational crusades for pure milk, for proper adminis- 
tration of public baths, for relief of needy families ; 

The large giving of recent years has sought educational 
purposes. Too many believe that charitable work and edu- 
cation are mutually exclusive ; it happens, therefore, that the 
lasting value of teaching done by charitable organizations 
is not properly recognized. 

Much work done by colleges and schools is charity. The 
best work done by charitable societies is educational. The 
student whose rich father pays $150 for college instruction 
that costs $500 is no less a recipient of charity than the poor 
mother who buys pure milk for her sick baby for less than 
the cost of production; that mother is learning just as truly 
as is the college student. Whatever the field of its benefac- 
tion, no endowment can be truly educational that does not 
so apply truth to man's environment, that obstacles to human 
happiness may progressively decrease, and that opportunity 
for happiness may progressively increase. 



CLEAN MILK 

FOR 

NEW YORK CITY 



REPORT 

OF THE 

N. Y. MILK CONFERENCE 



HELD 

NOVEMBER TWENTIETH, 1906 

AT 

THE N. Y. ACADEMY OF MEDICINE 



THE NEW YORK ASSOCIATION 

FOR IMPROVING THE CONDITION 

OF THE POOR 

JOINTLY WITH 

THE DEPARTMENT OF HEALTH 
REPRESENTATIVE PHYSICIANS 

AND 

HEALTH OFFICERS 

105 EAST TWENTY-SECOND STREET 
348-349 Gramercy 






INDEX 



Program of Conference, giving "Essential Facts," etc 6, 7, 8,9 

Subjects Considered: 

Skim Milk 12, 13, 14, 15, 16, 17, 60 

Pasteurization 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 50 

Infants' Milk Depots > 31, 41, 50 

Model Milk Shops 41, 65 

Inspection 56, 69 

Legislation 76, 80 

Education 69, 75 

Bacterial Standard 76, 77, 78, 80 

Commercial Pasteurization 26, 29, 31, 50 

Diseased Cattle 24, 27, 78, 79, 80 

Diseased Persons Handling Milk 47, 79 

Ice 72, 73, 74 

Inspectors, How Many 57, 62, 65, 66 

Junior Sea Breeze 10, 36 

Maryland Traveling School 69, 70, 71 

Pollution of Cans and Bottles 51, 53, 76, 80 

Resolutions 50, 56, 75, 81 

Score Card for Dairies 44, 45 

Score Card for Milk Shops 57, 60 

Sealing of Cans at Creameries 76, 79, 80 

Sterilization of Cms and Bottles 52, 56, 79 

Teachers' College Milk Exhibit 69, 71, 73, 81 

Speakers: 

Ager, Louis C ; 34, 35, 74 

Allen, William H t'.r.j 49, 51, 67 

Armstrong, S. T l»l 55 

Bartley, E. H V.* 25, 49, 55 

Bensel, Walter 51, 52, 55, 62, 66, 67, 76 

Chapin, Henry D 72 

Coit, Henry L 54 

Cutting, R. Fulton 11, 16 

Darlington, Commissioner 16, 18, 24, 27, 28, 29, 39 

Flanders, George L 71,72 

Freeman, Rowland G 15, 17, 26, 50, 75 

Fulton, John S 17, 69, 71 

Goler, George W 15, 25, 31, 34, 53, 54, 78 

Green, Dr., Supt. Straus Laboratory 18, 40, 41 

Greene, Commissioner W. D 23, 27, 50, 76 

Harris, E. Eliot 17, 28 

Holt, L. Emmett 36, 38, 52 

Hebberd, Commissioner Robert 66, 67, 80 

Hunt, A. Clark 47, 48 

Lane, Mr. Clarence B 43, 46, 47, 49, 51, 56, 62 

Lederle, Ernst J 12, 15, SO 

Northrup, William Perry 38, 39 

Opdycke, Leonard E 52 

Park, Wm. H 29, 53, 77, 80 

Pearson, R. A 18, 41, 55, 68, 74 

Straus, Nathan 19 23 

Vulte, H. T .'.73 

Wickersham, Geo. W H 

Williams, Linsly R 35^ 67^ 74 

Summary 81, 82, 83 

Permanent Committee 5, 75 

Oifi 

A athor. 
KOV 27 190? 






THE BATTLE FOR PURE MILK 
IN NEW YORK CITY 

In 1842 Robert M. Hartley, one of the founders of the 
New York Association for Improving the Condition of the 
Poor, wrote what was then said to be the only volume in the 
English language devoted to the scientific treatment of milk 
production. In 1850 it was republished in more popular 
form, 'The Cow and Dairy," and was a potent factor in the 
Swill Milk" agitation and reform that followed. The As- 
sociation was instrumental in having passed the law of 1864 
which prohibited the adulteration of milk. But unenforced 
laws do not insure clean milk, so two years ago a move- 
ment was begun to secure more milk inspectors. 

In the summer of 1905 at Commissioner Darlington's re- 
quest the Association furnished the Health Department an 
mspector who, from April 1st to August 5th, made 2,900 
inspections, examined 3,770 specimens, took 2G4 samples 
and destroyed 6,739 quarts of adulterated milk. Fiftv-one 
arrests for adulteration resulted in the conviction of 47 'deal- 
ers out of 49 tried. The Commissioner also transferred to 
milk inspection 150 sanitary officers from other fields for a 
time. 

Such work by 50 or more inspectors would soon produce 
tel ing results, for after all the best possible inspector of 
milk is the man who sells it and who is unwilling to have 
his milk destroyed and to stand trial for violation of the law. 

In 1906 the Association assisted in obtaining an appro- 
priation which enabled the Department of Health to double 
its stafif of milk inspectors, and co-operated with the Evenin<r 
IVorld^ m an enthusiastic campaign which led to a marked 
reduction m infant mortalitv, saving several hundred lives 
between July and September. 

July and August, the deadly months for summer-sick 
little children, saw columns of each dav's Evening World 
devoted to simple instruction and illustrated talks on the 
proper care of "infants," and invitations to send the Evening 



4 PREVIOUS SPORADIC EFFORTS 

World or the A. I. C. P. notices of illness of babies, all of 
which notices received prompt attention, chiefly by physi- 
cians from the Department of Health. 

In this crusade Junior Sea Breeze, a summer camp for 
sick babies, conducted by the A. I. C. P. for Mr. John D. 
Rockefeller, at the foot of East 65th street, played an im- 
portant part. Hundreds of babies were received and cared 
for, and the watchwords, often reiterated, were clean air, 

CLEAN MILK AND CLEAN BABIES. MotllCrS werC taUght hoW 

to care for and feed their babies, furnishing strong proof of 
the value and need for such teaching, and of the eagerness 
with which ignorant mothers respond to wisely conducted 
attempts to advise and educate them. 

All these efforts, however, and others by the Health De- 
partment and the County Medical Society Milk Commission 
and those who have intervened from time to time, excel- 
lent and helpful as some of them have been, have not suffi- 
ciently met the difficulties of the great problem. They have 
been sporadic, occasional, inharmonious and have not been 
backed by an enlightened public understanding and opinion. 
Some comprehensive and sustained movement was de- 
manded that should bring into effective co-operation all the 
interests involved, those of production, handling, distribu- 
tion and official oversight and also those of the consumer. 

Representing those engaged in the production, handling 
and distribution of milk many of the lar^gest dealers and 
owners of creameries, under the wise leadership of former 
Health Commissioner Lederle, organized the Association 
for Improving the ]\Iilk Supply of New York. 

The New York Association for Improving the Condi- 
tion of the Poor, feeling that the history of its connection 
with the subject and its relation to those of the people least 
able to help themiselves justified their accepting the responsi- 
bility of representing the consumer, called the conference as 
the first step in such a movement, a conference of those best 
qualified by professional and official experience to suggest 
the wisest measures. 

The Health Commissioner and twenty New York physi- 
cians connected with children's hospitals and asylums and 
with the County Medical Society Commission, and fifteen 



PERMANENT COMMITTEE 5 

health officers of New York and adjoining States and the 
Acting Chief of the Dairying Division of the National De- 
partment of Agriculture, became members of the Confer- 
ence. The record of their deliberations is here presented. 

{See Summary, pages 81-83) 



PERMANENT COMMITTEE 



In accordance with the request of the Conference, the 
Association for Improving the Condition of the Poor has 
invited the following named men, who have accepted ap- 
pointment, to act as a committee to continue the work in 
co-operation with the Department of Health and the County 
Medical Society and all those engaged in or related to the 
production, handling and distribution of milk. 



Ernest Hamlin Abbott 

William H. Allen 

Hugh D. Auchincloss 

E. H. Hartley, M. D.. 

Pres. Nicholas Murray Butler 

R. Fulton Cutting 

Richard Harding Davis 

Haven Emerson, M. D. 

Simon Flexner, M. D. 

Rowland G. Freeman, M. D. 

Joseph N. Francolini 

Rt. Rev. David H. Greer 

Arthur M. Harris 

E. Eliot Harris, M. D. 

Frederick Trevor Hill 

L. Emmett Holt, M. D. 

Edward F. Hurd, M. D. 

John S. Huyler 

Ernst J. Lederle, Ph. D. 



A. J. MiLBANK 

Cleveland Moffett 

Robert C. Ogden 

Percy R. Pyne 

Joseph H. Raymond, M. D. 

Jacob A. Riis 

Charles T. Root 

John E. Sayles 

DeWitt J. Seligman 

Mortimer L. Schiff 

Samuel Sloan, Jr. 

Theodore B. Starr 

Nathan Straus 

E. H. Van Ingen 

Prof. H. T. Vulte 

Rev. William J. White 

George W. Wickersham 

LiNSLY R. Williams, M. D. 

Stephen G. Williams 



For further information or for copies of this Report, address 
A. I. C. P., 105 East 22d street, New York City. 



FACSIMILE OF CONFERENCE PROGRAM 



Clean Milk for New York City 

CONFERENCE 

ROOM 44, N. Y. ACADEMY OF MEDICINE 

NO. 17 WEST 43D STREE^T 

November 20th. 1906, Tuesday 3 p. m. and 8 p. m. 



ESSENTIAL FACTS AS TO 
NEW YORK CITY. 

Manhattan's Infant Mortality. 

(UNDER 5 YRS.) 

Tune tp September, 1904, 4,428. 

June to September, 1905, 4,687. 

'- June to September, 1906, 4,428. 

Daily Consumption of Milk. 

1,600,000 qts. 

% in gt. bottles*. 

% in 40-qt. cans. 

"Certified," 10,000 qts. 

"Inspected," 3,000 qts. 

24 to 48 hours old on arrival. 

Comes From 

30,000 dairies, 40 to 400 miles distant. 
600 creameries— 105 proprietors. 
10 city railroad depots. 

Sold In 

12,000 places, mostly from cans. 
Sale of skim-milk prohibited. 

Milk Law Violations. 1905. 

Destroyed, 39,618 qts. 
Arrests. 806. 
Fines, $16,435. 

New York City Inspectors. 

14 in country since July ; might make rounds not oftener 
than once a year. 

(ForSyrs before, only 2 ; previously no na.) 
jLG in' City, might make rounds in SO to 40 days. 
(Before July, 14.) 



FACSIMILE OF CONFERENCE PROGRAM 



POINTS OF AGREEMENT. 

CleanliAess is the supreme requisite, from 
cow to constimer. 

Cows mustbe healthy, persons free from contagious diseases, 
premises clean, water pure, utensils clean, cans and 
bottles sterile, shops sanitary. 

Temperature is second essential. 

500 F. or lov/er at dairy. 

450 F. at creamery. 

450 F. or less during transportation. 

Not above oO^ when sold to the consumer. 

As to Pasteurization. 

Not necessary for absolutely clean milk. 

Destroys benign as well as harmful germs. 

Disease germs develop more rapidly th.an in pure raw milk. 

True, 1550 for 30 minutes to 167° for 20 minutes. 

Cost per qt., estimated, V4 to Vz ct. 

Commercial, 165° for 16 seconds. 

Cost per qt., negligible. 

As to Inspection. 

Some inspection needed within the City. 
Some inspection needed of dairy and creamery. 

WHAT NEXT STEPS SHOULD NEW 
YORK TAKE? 
Skim-Milk. 

Should its sale be permitted ? 

Under what conditions ? 

How would this aftect price of whole milk ? 

Pasteurization. 

Should pasteurization be made compulsory ? 
For what portion of the supply ? 
At whose expense ? 

Would it increase price of milk ? 

Does it render inspection unnecessary ? 

Does it reduce need for inspection ? 

Should sale of re-pasteurized milk or cream be permitted ? 

Should bottles show whether true or commercial pasteuri- 
zation is used ? 

Infants Milk Depots. 

Should they use pasteurized or clean milk ? 
Are municipal depots desirable ? 
Should private philanthropy support depots ? 
How many depots would be required m Nev/ York City ? 
Is Rochester experience applicable to New York City ? 
What educational work is possible in connection with milk 
Repots ? 



FACSIMILE OF CONFERENCE PROGRAM 



Model Milk Shops. 

What may safely be sold in connection with milk ? 

Should law discourage other than model shops ? 

Are present sanitary laws rigid enough ? 

Should private capita! be encouraged to establish shops ? 

Is it practicable to prohibit use of cans ? 

What provision can be demanded for proper refrigeration ? 

What for receiving milk before b'.is iness hours when delivered 

from stations ? 
What for sterilization of utensils and bottles ? 
What for attendants' dress and care of person ? 
Would such restrictions increase price ? 

Inspection. 

Is it practicable by inspection alone to secure a clean milk 

supply ? 
Will it protect against more dangerous forms of infection ? 
How many inspectors does New York City need ? 

Within the City ? 

Among country dairies and creameries ? 
How many inspectors should the State employ ? 



Legislation. 



What needed as to diseased cattle ? 

What as to diseases of persons producing or handling milk ? 

Is present sanitary code sufficient ? 

Shall law require sterilization of all milk cans and bottles by 
milk company or creamery before returned to farms or 
refilled ? 

Shall sealing cans at creameries be required ? 

Shall transferring from one can to another or from can to 
bottle in open street be made a misdemeanor ? 

Shall pollution of milk cans and bottles be made a misde- 
meanor ? 

Shall bacterial standard be established ? 

Is state supervision now adequate ? 

What further legislation is needed ? 

Does present law prescribe adequate penalties ? 

Education. 

Should state system of lectures before agricultural institutes 

be extended ? 
Should Maryland plan of traveling school be adopted as 

means of reaching producer ? 
What can be done to assist Teachers College in its plan for 

milk exhibit ? 
What can be done to teach mothers to detect unclean milk 

and to care properly for milk purchased ? 
How can tenement mothers keep milk at proper temperature? 
Can nothing be done to increase the supply and cheapen the 

price of ice ? 
Is it desirable that a local committee be formed to cooperate 

with the Department of Health and County Medical 

Society ? 



FACSIMILE OF CONFERENCE PROGRAM 



Members of Conference 

Health Commissioner, Thomas Darlington 
Dr. Rowland G. Freeman 
Dr. Joseph H. Raymond 



Dr. Louis C. Acer 

Dr. S. T. Armstrong 

Dr. E. H. Bartley 

Dr. Walter Bensel 

Dr. Herman M. Biggs 

Dr. John Winters Brannan 

Pres. Nicholas Murray Butler 

Dr. Henry D. Chapin 

Dr. H. L. Coit 

Prof. H. W. Conn 

Dr. E. K. Dunham 

Dr. John F. FitzGerald 

AssT. CoMR. Geo. L. Flanders 

Dr. Simon Flexner 

Dr. John S. Fulton 

Dr. Geo. W. Goler 

CoMR. Walter D. Greene 

Dr. Charles Harrington 

Dr. E. Eliot Harris 



Joined with 

A. I.e. P. 

in issuing call. 



Dr. L. Emmett Holt 
Dr. a. Clark Hunt 
CoMR. Robert Hebberd 
Dr. a. Jacobi 
Dr. Alexander Lambert 
Mr. Clarence B. Lane 
Dr. Ernst J. Lederle 
Dr. Henry Mitchell 
Dr. Wm. Perry Northrup 
Dr. Horst Oertel 
Dr. W. H. Park 
Prof. R. A. Pearson 
Prof. Leonard Pearson 
Mr. Nathan Straus 
Dr. G. H. Swift 
Prof. H. T. Vulte 
CoMR. C. A. Wieting 
Dr. Linsly R. Williams 
Dr. Joseph E. Winters 



Association for Improving the 

R. Fulton Cutting, 

President 

Percy R. Pyne, 

Vice-President 

Howard Townsend, 

Vice-President 

John Seely Ward, Jr., 
Vice-President 

Geo. W. Wickersham, 



Condition of the Poor 

Robert Shaw Minturn, 
Treasurer 

Leonard E. Opdycke, 

Secretary 

John L. Cadwallader, 

Counsel 

William H. Allen, 

General Agent 

Vice-President 



Conference Committee 

Geo. W. Wickersham, Chairman 



Percy R. Pyne 



Richard Welling 



Physicians and Health Officers 

Members of Corvferervce 

Health Commissioner, Thomas Darlington ^ Joined with 

Dr. Rowland G. Freeman Y . ^•■'•>-^- , 

Dr. Joseph H. Raymond . , J »" tssutngcall. 

Dr. Louis C. Acer, L. I. College Hospital and Pathologist Nor- 
wegian Hospital. . 

Dr. S. T. Armstrong, Supt. Bellevue Hospital. 

Dr. E. H. Bartley, L. I. College Hospital and Attending 
Physician Sheltering Arms Nursery. 

Dr. Walter Bensel, Asst. Sanitay Supt. N. Y. City Depart- 
ment of Health. . ^. , »r -r , 

Dr. Herman M. Biggs, Medical Officer of the City of New York. 

Dr. John Winters Brannan, President Board of Trustees of 
Bellevue and Allied Hospitals. 

President Nicholas Murray Butler, Columbia University. 

Dr. Henry D. Chapin, Prof. Diseases of Children, N. Y. Post- 
Graduate Medical School and Hospital. 

Dr. H. L. Coit, Newark, N. J., The Father of Certified Milk. 

Professor H. W. Conn, Professor Bacteriology, Wesleyan Uni- 
versity. 

Dr. E. K. Dunham, Professor of Pathology, University and 
Bellevue Hospital Medical College. 

Dr. John F. FitzGerald, Supt. Kings County Hospital. 

Geo. L. Flanders, Asst. Commissioner Agriculture, State of 
New York. 

Dr. Simon Flexner, Director Rockefeller Institute for Medical 
Research. 

Dr. John S. Fulton, Secretary Maryland State Board of 
Health. 

Dr. George W. Goler, Health Officer, Rochester, N. Y. 

Dr. Charles Harrington, Secretary Massachusetts State Board 
of Health. 

Dr. Walter D. Greene, Commissioner of Health, Buffalo, N. Y. 

Dr. E. Eliot Harris, Visiting Physician City Children's 
Hospital. 

Commissioner Robert W. Hebberd, Department of Charities. 

Dr. L. Emmett Holt, Professor Children's Diseases, Columbia 
University. 

Dr. a. Clark Hunt, Asst. Secretary New Jersey State Board 
of Health. 

Dr. a. Jacobi, Consulting Physician, Mt. Sinai Hospital. 

Dr. Alexander Lambert, Consulting Physician N. Y. In- 
firmary for Women and Children. 

Mr. Clarence B. Lane, Asst. Chief Dairying Division, Bureau 
of Animal Industry, Dept. of Agriculture, Washington, D. C. 

Dr. Ernst J. Lederle, former New York City Health Com- 
missioner. 

Dr. William Perry Northrup, Visiting Physician Presbyterian 
and Foundling Hospitals. 

Dr. Horst Oertel, Pathologist City Hospital. 

Dr. W. H. Park, Director Research Laboratories New York 
City Department of Health. 

Prof. Leonard Pearson, Dean Dept. Vet. Med., University Pa. 

Prof. R. A. Pearson, Department of Dairying, Cornell University. 

Mr. Nathan Straus, Straus Milk Depots. 

Dr. G. H. Swift, Visiting Physician St. Mary's Free Hospital 
for Children. 

Prof. H. T. Vulte, Teachers College. 

Dr. Linsly R. Williams, Chief of Clinic, Department of 
Medicine, Vanderbilt Clinic. 

Dr. Joseph E. Winters, Professor Children's Diseases Medical 
Department Cornell University. 



THE CONFERENCE CONVENES 11 



PROCEEDINGS. 



Mr. Gutting: Gentlemen and Ladies — The conference 
has been called to discuss a question of vital importance, it 
seems to us, yet one which is so far of but very little popular 
interest. It is easy enough to agitate this City on the sub- 
ject of Rapid Transit or the lower price of gas, but when it 
comes to a question of the milk supply it is the hardest 
thing in the world, it seems, to create any interest ; largely 
because of lack of information on the part of people other- 
wise well informed. 

It is sixty years ago, I think, since the Association for 
the Improvement of the Condition of the Poor, wdiich I rep- 
resent, took the first steps to secure a little better milk sup- 
ply in this City, and it kept up the agitation through the 
newspapers and in other ways until the Law of 1864 was 
passed which prohibited the adulteration of milk. 

The Association has been derelict in not carrying on the 
agitation since that time, and in not pursuing it as it ought 
to, but it has awakened again to its responsibility and has 
asked you to come here to-day in order to discuss this very 
important question. 

Now, there is a great deal to talk about this afternoon. 
There will be, I suppose, considerable difference of opinion 
upon a variety of subjects, but I am sure we are all one in 
purpose. We don't want to waste time at all about what we 
have to do. I would be glad if somebody would nominate 
a permanent Chairman. 

Mr, George W, Wickersham was nominated and duly 
elected Chairman. 

The Ghairman; Ladies and Gentlemen — If agreeable, 
I would ask Mr. Sayles to act as Secretary of the meeting. 
We are not here to waste time in oratory and I suggest the 
rule be that the discussion be limited to the questions sug- 
gested in the leaflet which is in your hands, and I would 
also suggest that so far as possible gentlemen limit their 
remarks so as not to exceed ten minutes. 



12 SKIM MILK IN NEW YORK 

In order to start the discussion I will ask Dr. Lederle to 
speak upon the first question, skim milk. 

Dr. Ledctic: Mr. Chairman — Before taking up the 
special subject assigned to me, permit me to say a few words 
on the general milk conditions of our city. 

Your very commendable movement may be misunder- 
stood, especially by those coming from other cities, unless 
we start fairly by stating what the present condition of our 
milk supply is. 

I am fairly conversant with conditions both from the 
standpoint of the sanitary authorities and that of the dealer. 
The milk supply of our city was never in as good condition 
from every standpoint. 

Our Health Department is doing more work and better 
work than ever before both in the city and country. There 
has never before been done the amount of work at the cream- 
eries and among the farmers. I am in a position to know 
that there never before has been so much independent work 
done in the line of improvement at the creameries and in 
transportation and general improvements, and never has 
there been such effective co-operation with the Department 
of Health by the milk dealers. 

The sensational statements of universally bad conditions 
of our milk supply are false, unfair and an injustice to the 
authorities, the dealers and to our city. We are all agreed 
that there is still room for very decided improvement, but in- 
telHgent suggestions for such improvement can only be made 
on the basis of accurate information as to existing condi- 
tions. 

New York City is the only place in the 
Skim world, I believe, where it is a crime to sell 

Milfc. skim milk, even when properly labeled. 

One result of this official prohibition is that 
our people are convinced that skim milk is injurious or un- 
wholesome, a most unfortunate and false impression. 

When our milk laws were first enacted, skim milk was 
prepared by removing the cream from whole milk which 
had been allov^ed to set for from twelve to twenty-four 
hours. The skim milk was necessarily old, stale and not in 



SKIM MILK WASTE 13 

fit condition to transport. The introduction of centrifugal 
machines for separating the cream from milk has made it 
possible to send skim milk to the market as fresh as the 
whole milk, thus removing the only possible valid objection 
to sale of skim milk as such. 

Competent authorities tell us that an absolute prohibition 
against the sale of skim milk must be unconstitutional. 

This question has never been seriously taken up for the 
following reasons : 

The authorities have not opposed a change in the law on 
account of supposed or actual difficulties of regulating the 
sale and preventing fraud. 

The milk dealers are not insisting upon a change because 
there is no unanimity of feeling among them of the desira- 
bility of such change, mainly on account of the uncertainty 
of the effect it would have on the milk trade. 

The consumer has not interested himself, probably be- 
cause he has not appreciated the great value of skim milk 
as a cheap food. Let us consider what effect this law has 
had. 

New York City is, of course, the market for almost all 
of the milk produced in our State. The complete exclusion 
of skim milk from this market has resulted in the develop- 
ment of a very large industry, the preparation of casein, a 
dry curd which is used principally as a glue substitute in 
the manufacture and coating of paper, in the preparation 
of cold-water paints and for many other technical purposes. 

Eighty-five creameries in this State produce annually : 
5,000,000 lbs. of dry casein from 80,000,000 quarts of skim 
milk, or 222,000 quarts of skim milk per day. 

The creamery averages five cents per lb. for the sale of 
this casein. 

100 lbs. of skim milk make 3 lbs. casein, or the skim milk 
is worth for casein 12f cents (approximately) per can of 
forty quarts. 

Furthermore, unless the sugar is extracted from the 
whey, a further equivalent amount of food is lost. We are 
diverting five millions of pounds of valuable food product to 
purely technical uses as a glue substitute and paint. 

As to the value of skim milk as a food it will hardly be 



14 SKIM MILK AS FOOD 

necessary for me to dwell at length at this time, although it 
is not generally appreciated. 

When taken with bread or used in cooking it forms a 
very nutritious addition to our food. Two and one-half 
quarts of skim milk will furnish the same amount of protein 
and have about the same fuel value as a pound of "round 
steak." 

Round steak about 16 cents. 

Skim milk (@ 3c.) 7^ cents, including cost of handling, 
icing, transportation and delivery in New York City, all of 
which would be practically the same as for whole milk. 

Skim milk could be used for the following purposes: 
Cracker bakers ; bakers in general ; in restaurants and house- 
hold; for cooking purposes; preparation of a substitute of 
equal or greater value; for buttermilk; as a beverage for 
adults. 

I would suggest that in order to make it possible to use 
skim milk for manufacturing purposes, solely at first, the 
Sanitary Code be amended permitting the issuing of permits 
to bring skim milk into the city under special regulations 
to be used for the purposes stated. Gradually, as the matter 
has been more closely studied and is better understood, this 
milk could be sold for use for general purposes, excepting 
the feeding of infants and children. 

As to what effect the sale of skim milk will have on the 
price of whole milk, it is not possible to predict with any 
degree of certainty. Those most competent to give opinions 
believe that the effect will be in a large measure to tend to 
keep down the price of whole milk, which, on account of in- 
creasing shortage, increase in cost of transportation, the 
more liberal use of ice at much greater cost, the greater ex- 
penditures following the enforcement of more stringent 
regulations on the farm, at the creameries, during trans- 
portation and in the retail stores, must soon materially ad- 
vance. 

In view of all this, it would seem particularly fitting that 
the Association for Improving the Condition of the Poor 
should take up the investigation of this phase of the milk 
question in earnest and its proper solution will, I feel certain, 
bring about very beneficial results to the people. 



SALE OF SKIM MILK 15 

Dn Golet: So far as Dr. Lederle has gone, I am 
heartily in accord with what he has said, but it does not 
seem to me that he has touched on one very important 
phase of the question, and that is, under what conditions 
the sale of skim-milk should be permitted. 

That, it seems to me, is the important question, a very 
important one. Should we permit skim-milk to be sold 
upon wagons along with whole milk? Milk men are 
human. Would they not sell skim-milk for whole milk? 

What efifect would the sale of skim-milk have, for in- 
stance, upon the price of whole milk? 

I would like very much to ask Dr. Lederle under what 
conditions he would permit the sale of skim-milk. 

Df^ Ledcfle: Why, as I suggested in the first place, I 
would not permit its general sale. I would allow it to 
come in for manufacturing purposes only; for the use of 
bakeries and for baking purposes only, under special per- 
mit; and on further investigation, if it was thought desir- 
able, and I think it will be found desirable, allow it to come 
in for general use under restrictions. 

I don't know that we are ready to go into all the de- 
tails of that. As for the efifect on the price of whole milk, 
I think I have suggested that competent authorities are of 
the opinion that the efifect will be to hold down the advance 
that is sure to come in the price of whole milk. 

Df« Freeman: It seems to me ridiculous that skim-milk 
should have to be dried in order to be brought into New York 
City. Skim-milk, after it is dried, may be brought in, 
whereas skim-milk unchanged is prohibited from entrance, 
although it is a very valuable food. 

I see no reason why it shouldn't be carried in wagons 
as other milk is carried. It is no more dangerous than the 
water that goes into other milk. (Laughter.) There can 
be no possible objection to its introduction. The prohibition 
of the sale of skim-milk is an injustice to the producer and 
the consumer. I think that neither skim-milk nor any other 
pure food product should be prohibited from being sold 
provided it is plainly labeled. It seems to me that this is a 
matter for the inspectors to take care of. 



16 SKIM MILK DANGERS 

Commissioner Darlingfton: I think this a very serious 
question, indeed. The entrance of skim-milk into the city 
would no doubt reduce the price of pure milk; and it is a 
good food under certain circumstances; but is the city 
prepared to appropriate a sufficient amount of money to 
watch the sale? Would it be possible to maintain the 
number of inspectors it would be necessary to have under 
the present number of milk permits now issued in the city 
of New York ? It is very difficult as it is to watch the milk. 
It would be much more difficult if skim-milk was generally 
sold. 

You have simply to look at the bottom of the program 
which has been distributed here, where it says : ''Milk-law 
violations, 1905; arrests, 806, and fines, $16,435," which 
speaks volumes for the difficulties already encountered. 
It would be endless if skim-milk was generally sold. 

Furthermore, there is the danger of giving skim-milk 
to infants. The difficulty does not alone consist in bac- 
teria in the milk. When we modify milk for babies it is 
that we shall have more cream and less casein, and skim- 
milk is largely casein and water. 

Does anyone think that of the twelve thousand permits 
in the city of New York a large percentage of those people 
would not endeavor to sell that milk improperly labeled? 
How many inspectors would it take to follow that up? 

No doubt it is a good food, but there are grave dangers 
in its general sale. You cannot make people good entirely 
through law. Conviction comes from the heart, though 
public opinion is a powerful factor. It would take a long 
time before the 12,000 people with permits would have 
sufficient moral sense so that every one of them would sell 
pure milk and never attempt to sell the skim-milk in place 
of it. 

Mr. Cutting: May I ask a question of those who are 
more familiar with the social side of it, as to whether if 
skim-milk was sold in New York for three cents a quart, 
even if properly labeled, a very large percentage of the 
poor would not prefer to buy skim-milk for their use all 
the time, simply because it was cheap? Wouldn't that be a 



SKIM MILK — NUTRITIVE VALUE 17 

fatal thing for us to do, to open an opportunity for that 
sort of thing? The very sale of the milk, it seems to me, 
even with the label, is a guarantee of its food value. The 
poor, I am afraid, would take unwise advantage of it. 

The Chairman: The Chair would suggest that per- 
haps the relative nutritive qualities of the two might be 
touched upon. 

Du Freeman: As to the nutritive value, the real 
nutritive value is in the skim. The fat furnishes heat, but 
the real value is in the proteid of milk. Although we feed 
milk with a higher percentage of fat than is present in the 
cows' milk, still it is not the fat we really rely upon to 
keep the child alive. As to the use of skim-milk instead of 
whole milk — well, some of them use tea for young children 
— I think the skim-milk would be much more valuable than 
the tea. (Laughter and applause.) 

Df. Fulton: It occurs to me that the city of New York 
has possibly extinguished an important sort of food, es- 
pecially for the tenement-house portion. 

At all events, we find in Baltimore that a considerable 
part of the output of skim-milk goes into the families of 
the foreign-born people who make a great variety of hand 
cheeses of it. It may be undesirable to feed babies with 
skim-milk. At the same time, I should think that cer- 
tainly preventing its sale for anything else is merely an ad- 
ministrative problem and should be readily solved. 

I do think it is an unusual spectacle for a large city 
to cut these people off from a sort of food which I am sure 
is important chiefly because it is cheap. 

The skim-milk, I say, in Baltimore goes into the hand 
cheeses made by the Jews, Lithuanians, and so forth. It 
is a food which is capable of being preserved for many 
months. 

Dr. Harris: Now, I am impressed with the value of 
skim-milk as a food, and its increased food value over beer 
and other things that are used (laughter) and at the same 
time I am alive to the fact that it is not a proper food to 



18 PASTEURIZATION 

give to infants and children. In Dr. Lederle's paper he 
spoke of it being used by cracker manufacturers, bakers, 
etc., and not by children. I am in favor of such use of skim 
milk. 

The question is whether the present force would be 
suf^cient to keep it out of the retail stores? 

Commissioner Darlington: It would not. I think it 
could be controlled so far as the sale to bakers is con- 
cerned, special consignments to certain places. 

Prof. R. A. Pearson: If I mistake not, everyone has 
admitted that there is some good in skim-milk, but there 
have been two objections raised to it. One is that it is a 
food which young children should not have, and there- 
fore its sale should not be permitted. 

It seems to me that it is not for us to act upon that 
suggestion because there are a great many foods young 
children should not have, and if we attempt to exclude 
them the list would be a long one. We should not begin 
with skim-milk. 

The o<.her objection is the one raised by Dr. Darlington, 
and that is the difficulty of preventing the sale of skim- 
milk by the 12,000 dealers who are selling whole milk. I 
appreciate that this is a very important objection. Now, I 
wish to ask the Commissioner of Health if that objection 
could be overcome if the sale of skim-milk were permitted 
only at places where whole milk is not sold, separate 
licenses being issued for the sale of skim-milk only and 
exclusively. The point is that the two products should not 
be sold in any case by the same person. 

Commissioner Darlingfton: I do not know. We would 
have to think of that very carefully. 

The Chairman: We will pass to the 
PAstcufUation. next subject, "Pasteurization." I had in- 
tended to call upon Mr. Nathan Straus, if 
he were present, to open this discussion. I believe, how- 
over, that he is represented here to-day by Dr. Green. 

Dr* Green: Mr. Straus intended to be here to-day. He 
had prepared a statement, which I shall be pleased to read. 



MR. NATHAN STRAUS ON, PASTEURIZATION 19 

Mn Straus' Paper: The greatest task confronting hu- 
manity to-day is the conquering of disease. 

We have met to discuss what we can do in our feeble 
way in the direction of solving a question of vital impor- 
tance, and I say to you that the phase of the problem which 
we are to consider has not received the attention its sur- 
passing needs deserve. 

I have been criticized for preaching the danger of our 
milk supply, for saying that the most destructive of all 
agents of disease and death is the common, ordinary milk 
offered for consumption in our cities. I welcome this criti- 
cism, because it is only through discussion and agitation that 
the public is aroused. 

I think it requires no argument to prove that our milk 
supply, even with all the precautions thrown around it, needs 
further and radical reform, but I do not believe that it is 
generally understood to what degree it is responsible for 
suffering and death, particularly among young children. 

You know that in this country one child out of every 
three that are born dies before the age of five is reached, and 
I claim that the majority of these deaths are preventable. 

I can conceive of no work that should appeal more 
strongly to a people or to a government than the saving of 
infant lives. 

Scientists are devoting their best efforts throughout the 
world to finding remedies for the prevention and cure of 
the world's greatest scourge, the most dreaded and deadly 
of diseases — Consumption, well named the "White Plague." 

Last year in the International Tuberculosis Congress 
held in Paris, Professor von Behring expressed the opinion 
that one of the most useful results of the Congress was the 
acceptance of the fact by all the delegates that bovine tuber- 
culosis is transmissible to human beings, the bovine bacilli 
being more dangerous even than are the human bacilli. 

Fourteen years ago I lived in the Adirondacks, and to 
be sure of having pure milk for my family, we kept our own 
cow. One day the cow fell sick and died suddenly. We 
thought she had been poisoned and called in a veterinary 
surgeon. He found the cause of her death easily enough — 
her lungs had been eaten away with consumption. 



20 MR NATHAN STRAUS ON PASTEURIZATION 

So you see that when we thought we were drinking pure, 
wholesome milk, we were taking into our systems the germs 
of disease. From that time, no more raw milk was used in 
our family. 

That was fourteen years ago. Now I will tell you of a 
recent experience to prove to you the correctness of my 
convictions. I met one of our prominent butchers a short 
time ago, and we talked about pure food. I asked him to 
tell me something about the condition of the cows slaugh- 
tered for this market. He told me that out of a herd of one 
hundred and eleven that he recently bought, twenty-seven 
were found to have diseased lungs — were far gone in con- 
sumption. He also said that about ten per cent, of all cows 
bought for slaughter in this market were afflicted with the 
same disease. 

I asked his permission to use this information, and 
though for obvious reasons he did not wish me to use his 
name, he sent me a letter, which I have as proof of the 
statement. 

Another fact which has come to my knowledge is that 
in one of the greatest dairy farms of this State, stocked 
with high-bred, registered cows, last year over one hundred 
had to be killed because they had developed consumption. 
This occurred on a farm where to my personal knowledge 
the most scrupulous cleanliness prevails, and where every- 
thing is conducted on the most thorough scientific principles 
of sanitation. If I had been asked, **Is there any milk 
brought to this market fit for use in its raw state ?" I should 
have unhesitatingly recommended the milk from this farm 
as the best. 

Not long ago I had a letter from a very wealthy resident 
of this city, a man whose name you all know. He wrote 
me that to prevent any possibility of the milk provided for 
his little son being impure, he had built a new cow barn at 
his country place, and at great trouble and expense selected 
eight of the finest and best bred young cows, registered 
Alderneys, for his private use. One of the cows took sick 
shortly after, and he had her killed. A post-mortem devel- 
oped that the cow had tuberculosis. He then had the re- 
maining cows tested by a representative of the State Agri- 



MR. NATHAN STRAUS ON PASTEURIZATION 21 

cultural Department, and he pronounced Hve of the remain- 
ing seven cows tubercular. 

And he cried out to me: "Where and how can I get 
milk fit to give my child?" 

Thirteen years ago I was asked by the Editor of the 
Forum to write an article for his publication on the necessity 
for pure milk. 

I did so, and my article was returned to me with the re- 
quest that I eliminate a certain paragraph — he said it was 
too radical, too daring. The paragraph was as follows, 
which was finally printed as a foot note : 

"Milk is not always good in proportion to the 
price paid for it, nor free from the germs of con- 
tagion because it has come from cattle of aristo- 
cratic lineage. The latter quality, as recent ex- 
perience has shown, carries with it a special sus- 
ceptibility to tuberculosis." 

Thirteen years ago I believed that the pasteurization of 
milk was the only remedy. To-day I KNOW IT. 

In June, 1895, Dr. Jacobi, in endorsing the use of pas- 
teurized milk, wrote me: "There is nothing so instructive 
as a success, and a single practical proof speaks louder than 
any number of volumes." Therefore, I will cite the case of 
a public institution where the death rate of the children was 
so high that it became a public scandal. This was on Ran- 
dall's Island. Though the city had their own herd of cows, 
which were kept on the Island, carefully tended and appar- 
ently in perfect health, they did not succeed in reducing the 
death rate below forty-four per cent. At that time I was 
President of the Health Board, and the institution came 
under my direct charge. I had a chance to study the ap- 
palling conditions that still prevailed there. After I had re- 
signed from this office, encouraged by the results I had al- 
ready obtained in the city, I installed on the Island a com- 
plete plant for the pasteurization of milk. In the very first 
year of its operation, the death rate of the children made 
the astonishing drop of from 44 per cent, to 20 per cent. 
Remember, there was no other change made either in diet, 
hygiene or management of the institution. The rate was 
later reduced to the still lower figure of 16.5 per cent. 



22 MR. NATHAN STRAUS ON PASTEURIZATION 

Just think of the enormous saving of lives if pasteuriza- 
tion were generally adopted. 

I have done as much as one man could to establish and 
promote the use of pasteurized milk everywhere, but all that 
has been accomplished is merely a fraction of the good that 
could be done were the supply of pure milk made a muni- 
cipal function as much as the supply of pure water. There 
can be no question but that the supply of milk everywhere 
should be pasteurized, not only that intended for infants, 
since the use of raw milk for adults is almost equally fraught 
with danger. 

It has been said that the pasteurization of milk will not 
destroy the tubercle bacillus, but this assertion must have 
been made by some one not familiar with the process of 
pasteurization, or not familiar with the proofs on the sub- 
ject. 

Scientists agree that a temperature of 1G5 deg. for twenty 
minutes will destroy the tubercle bacillus. Dr. Smith, of 
Boston ; Pearson, of the University of Pennsylvania ; Bang, 
of Copenhagen; Russell, of the University of Wisconsin; 
Moore, of the New York State Agricultural Department, 
and Ravenel, of Philadelphia, all eminent scientists, are a 
unit in agreeing upon this. And as in the process of pasteur- 
ization the milk is heated to a temperature of 165 deg., and 
kept there for twenty minutes, it follows that the tubercle 
bacillus must be destroyed. 

If it were possible to secure pure, fresh milk direct from 
absolutely healthy cows in any large city, there would be no 
necessity for pasteurization. 

If it were possible to establish a system of public inspec- 
tion and examination of milk which would prevent the sup- 
ply of polluted milk, there would be no cause for pasteuriza- 
tion. 

If it were possible by legislation to obtain a milk supply 
from clean stables, after a careful process of milking, to 
have transportation to the city in perfectly clean and close 
vessels, then pasteurization would be unnecessary. 

But I am compelled to conclude, after years of study, 
that these conditions are absolutely impossible of attainment. 



MR. NATHAN STRAUS ON PASTEURIZATION 23 

Corrective laws have been passed, medical societies have 
directed their energies to a betterment of conditions, but I 
do not think it will be denied that a very large proportion of 
the milk now sold in New York City is unfit for consump- 
tion. 

No agitation for a better milk supply, by whatever meth- 
ods attempted, can be without good result, but I have pre- 
ferred to direct my work to the attainment of positive re- 
sults, and these I know can be attained by pasteurization 
only. 

While efforts directed toward the prevention of con- 
tamination at the source of supply are attended by many 
difficulties, and the net results, therefore, are extremely 
small, such efforts should not be abandoned. On the con- 
trary, even though milk be pasteurized, and I believe the 
time will come when the entire milk supply of all large 
cities will be pasteurized, there should be no relaxation of 
vigilance to prevent initial contamination. 

In the course of years human ingenuity may have found 
a means of entirely eliminating disease; it is for us to do 
our share with the light that is given us. 

Scientists play their part in adding to the sum total of 
human happiness, but the layman has no unimportant role. 
I believe the solution of the question before us is not scien- 
tific but practical. It is not cure — it is prevention. 

Public opinion is the greatest force in human achieve- 
ment to-day, and when the public have been sufficiently 
aroused to the fact that the prevention of disease is quite as 
essential as the erection and maintenance of hospitals for the 
cure of disease, we shall have the first requisite for intelli- 
gent legislation on this subject. Since the fact can easily be 
demonstrated that the conditions surrounding the milk sup- 
ply of our city entail an appalling penalty of suffering, dis- 
ease and death, surely prejudice, ignorance and criminal neg- 
lect of obvious precautions must have had their day. 

Health Commhsioner Greene: I think that the gentle- 
man in his paper struck the keynote, and that is that if we 
have a proper inspection of the milk at the dairy and proper 
inspection of the dairy, and proper bacteriological examin- 



24 PASTEURIZATION PERMITTED 

ation of the milk, it is not necessary to have it pasteurized. 
Until that time arrives I believe it should be pasteurized. 

In the Department of Health in Buffalo, I might say 
we have a bacteriological examination of 300 samples of 
milk every month. On the 19th of October the bacterio- 
logical examination showed streptococci and pus in a sample 
of milk sent in from the country. I sent a man out there 
the next day and he reported that one of the cows had a 
dilation of the udder and that there was pus in the milk. 

On November 13th, another sample very much the 
same was reported to me as containing streptococci and 
pus. I sent an inspector in whom I had the greatest confi- 
dence to the farm, and he came back with this report: 
That he found one cow with one of the teats giving a 
milk which was almost transparent, like water; the other 
three a milk which to the ocular inspection and to taste, 
looked and seemed perfect. He, however, brought that 
milk in to be examined. The cow's udder was perfectly 
healthy; there was no sore nor any ulcer of any kind. The 
cow was in good flesh, but yet there was a large amount of 
pus and streptococci in this milk. That had never been 
discovered in the city of Buffalo before this year, because 
we never had a bacteriological examination of milk, and 
we have been drinking that kind of milk ever since we 
have had milk coming into the city. If that cow was 
tubercular, if the lacteal ducts contained tuberculosis, people 
drinking that milk were very likely to be infected with tuber- 
culosis, i ;' 

If we have proper inspectors and inspections, then 
pasteurization is not necessary if the milk is clean, but 
there are two cases which go to show the necessity for 
inspection and for pasteurization if not properly inspected. 

Commissionef Darlington: Under the present rules of 
the Sanitary Code of the Health Department, the pasteuriza- 
tion of milk is permitted provided it is labeled "pasteurized." 

The query with me is, Should not the public do their 
own pasteurizing rather than have the city do it? There 
may be some people who do not want their milk pasteur- 
ized. I know of some. Even suppose it is a menace to 



PASTEURIZATION NOT COMPULSORY 25 

the community. Shall we pasteurize all our foods? There 
is danger from other foods. Shall we insist that they be 
partially cooked before they are sold? 

I think that is a legal question. It seems easy to 
say pasteurize milk, and cook it to 165 degrees, but sup- 
pose somebody does not want it that way? Milk can 
indeed be sold that way provided it is labeled and every- 
body can buy it. Is it not the first duty of the city to go 
into the State and see that every place is clean; go to the 
source of the milk supply, to see that the water is pure; 
the dairies clean ; the cows in good condition ; then to look 
after the creameries, and then the places where the milk 
is sold, and after that has all been done, if it be found that 
milk is not a proper food for infants because of the bacteria 
which it contains, take up the question whether or not the 
city should pasteurize it. 

Df. Bartlcy: The method of pasteurization that is 
adopted now is to heat it up to the pasteurizing point and 
suddenly cool it in an apparatus so it does not remain at a 
temperature of 165 or any other elevated temperature for 
more than a few seconds. 

It is news to me to know that the Health Department 
requires that all milk that is pasteurized must be so 
labeled. I know that a great deal of the milk that is sold 
in the city is pasteurized as described and not labeled. 

Dn Goler; I come from a small town in the western 
part of the State having about 200,000 people. For the 
last five or six years I ihave persistently and I think con- 
sistently fought the commercial pasteurizing of milk. 

Whatever people may want to do with milk after they 
get it home may be none of our business for the present, 
but if you look into the dairies from which the companies 
draw the milk for commercial pasteurization and see the 
conditions under which the milk is produced, I think that 
no one of you would be willing, so far as our experience 
goes, to have commercial pasteurization open in your own 
cities for your own consumption. 



26 COMMERCIAL PASTEURIZATION 

It seems to me that the commercial pasteurization of 
milk is a direct invitation to the milk men to be just as 
dirty as they m.ay be, if they only have some proper silver- 
plated apparatus that will remove the globules of dirt and 
hair and more or less solid materials, at the same time 
leaving- the soluble material in the milk. 

Du Freeman: In considering this subject, Mr. Chair- 
man, it seems to me we should know what commercial 
pasteurization is. Pasteurization was adopted after it was 
found that milk was full of germs, and it was found that 
boiling injured the milk and changed its chemical condition 
and that children fed upon it did not do as well. It was found 
that bacteria could be killed by lowering the temperature, 
but only when continued for a long time. One hundred and 
sixty-seven degrees for thirty minutes was thought suiBcient. 
Later investigation showed 155 F. for thirty minutes was 
also sufficient, and that was so low that no change took 
place in the taste of the milk, although most of the germs 
in the milk were killed. That sort of pasteurization is the 
kind that is used in households. 

It was also established that the milk should be kept in 
the vessel in which it was pasteurized, and that the milk 
should be cooled and kept cool, and should not be kept more 
than twenty-four hours after pasteurization. 

Now, in commercial pasteurization, the milk is run 
through a tube that heats it to 1G7 F. for a few seconds, and 
then is rapidly cooled, put into other receptacles and mar- 
keted. Such milk is found, on bacteriological examination, 
to contain many bacteria. As commercial pasteurization is 
used now, I believe it is almost entirely as a means of mar- 
keting dirty milk, milk that would not otherwise keep sweet 
until it reached the consumer. 

The use of commercial pasteurization should be con- 
demned from every point of view. I think the Board of 
Health should be congratulated for recently passing rules 
that such milk should be so labeled, because undoubtedly 
pasteurized milk was before that sold as raw. 

The Chairman: One of the questions in the program 



PASTEURIZE THE COW 27 

is whether pasteurization will render inspection unneces- 
sary or reduce the need for it. I would like to know what 
the Health Commissioner thinks of that. 

Commissioner Darlington: I don't think that it 
should, but I think that it likely would. 

Commissioner Greene: Whether pasteurization would 
decrease the inspection work, is that the question? I don't 
think that in inspecting milk the inspector ever looks for 
bacteria. If they are found at all it is in the laboratory. 
The inspection as I understand it is generally taken in the 
streets, in the factories and at the stations and is simply 
for adulterations that can be detected by ordinary appa- 
ratus or by the ordinary inspector and not by the expert in 
the laboratory. 

Our experience is that inspection does not cover the 
question that you are now discussing. Would it not be 
a good plan to begin at the other end and pasteurize the 
cow? Is it a good thing to allow the fountain to be con- 
stantly defiled and try to strain the stream at the other 
end? That is my view of it. You have 1,700,000 cows 
in the State of New York and what Mr. Straus said in his 
paper in regard to the cows that he examined is true, no 
doubt, for we have found it in a good many places. 

I know of a herd of cows in this State from which 
certified milk has been sold. They were exercising all pre- 
cautions to keep only the very best cows in that herd. When 
they tested for tuberculosis one of the cows, apparently 
healthy and wholesome, responded to the test, and the 
man who owned the cow, apparently one of the best in the 
herd, said : *T believe that this test is not accurate, but I 
will kill that cow and find out." They killed her, and 
ingrowing somewhere I think they found nearly k pint of 
pus indicating the presence of this disease. 

Now, would it be a bad idea to begin at the other end 
and sterilize, and weed out these cows and some way pro- 
vided that they shall not come into the State. I have asked 
for this a great many times and they tell us it costs too 
much money. How much money is it going to cost to 



28 PASTEURIZATION NOT DEMANDED 

Sterilize all the milk of the State and force people to use 
pasteurized milk whether they want it or not? 

Commissioner Darlington: I don't want to talk all 
the time but I want to say that that is just what the Board 
of Health in the city of New York is trying to do. We 
have commenced at the other end, with all of the cream- 
eries throughout the State of New York and those that 
supply New York City in northern Pennsylvania, northern 
New Jersey, western Massachusetts and Connecticut have 
all been inspected twice. Changes have been ordered and 
they have made the changes. Five hundred dairies weekly 
are being inspected by New York City inspectors, and it 
includes the cows, the stables, the barns, the water supply 
and everything in connection with those dairies. We have 
gone with our inspectors to these places just the same as if 
they were inside the city of New York, and changes have 
been ordered and these changes are being carried out to- 
day. 

Df. Harris: May I ask Dr. Darlington how he en- 
forces the authority of his inspectors outside of the city of 
New York? 

Commissioner Darlington: . It is very simple. When 
a man does not make these changes we prevent the milk 
being sold here as a menace and danger to the city. 

Dr, Harris: I would like to know how he knows the 
milk coming into New York City? 

Commissioner Darlington: . It is shipped direct on the 
railroad. 

Dr^ Harris: It seems to me that this is a question for 
the education of the pubHc, and the enforcement of any 
rule or law for pasteurization at this time will not meet 
with public approval. There is not a general public senti- 
ment to-day in favor of the pasteurization of milk, there- 
fore to form any law, any rule or regulation for the 
pasteurization of milk seems to me to be a waste of time. 
What is needed is education on the subject and then let 
public opinion decide. For myself I would rather have n»y 
milk pasteurized. 



PASTEURIZATION DEFENDED 29 

Commissioncf Datlington: The pasteurization that 
doesn't pasteurize is the present state of the process. 

Df^ Park: I think we should define more clearly what 
we mean by commercial pasteurization. If we are talking 
about pasteurization and mean three or four different things, 
and if we do not distinguish between ordinary milk and 
bad milk, we can, while really agreeing with each other, ap- 
parently disagree. 

Now, I only know a little of how commercial pasteur- 
ization is carried on in New York City, but I believe from 
what I do know that when a firm pasteurizes milk commer- 
cially, it does not necessarily allow less clean milk to be 
used, although undoubtedly the contrary is often true. 
When they don't pasteurize it, on hot days or various days, 
some of the milk would sour, or the milk would sour in the 
hands of the people keeping it that night or the next morn- 
ing, and these dealers found that by commercially pasteur- 
izing their milk it kept better through the twenty-four 
hours. 

We must limit in some way the term pasteurization. 
Probably it would be fair to insist on the raising of the milk 
to a temperature of 160 F. for half a minute or to an 
equivalent effect of lower heat for a longer time. Such a 
treatment will destroy probably 95 per cent, of the ordinary 
bacteria. It will destroy many typhoid germs; will destroy 
probably most of the scarlet fever germs. It will not destroy 
more than a small percentage of the tubercle bacilli. 

I don't beHeve that our Health Commissioner or Dr. 
Bensel or any one would say that this year or next year or 
in five years all the milk coming into New York City in 
the summer time can be used raw safely. The raw milk 
coming into the city in summer would, in my opinion, be 
improved by having it heated to 160° for one minute in the 
early hours, just before its distribution. At all seasons the 
milk would be rendered safer, as far as transmission of 
contagious diseases, by such treatment. For infants we 
must, when possible, seek not only a pure milk, but a longer 
exposure to heat, and this should be given from stations 
properly safeguarded. 



30 PASTEURIZATION ABROAD 

To sum up, I think it is as much a mistake to call com- 
mercial pasteurization a fraud as to say that commercial 
pasteurization does as much as proper pasteurization. The 
fact that milk is pasteurized does not greatly lessen the need 
for farm inspection. The pasteurizing plants themselves 
should be under the constant supervision of the sanitary 
authorities. 

Dr. Lederle: I know in Berlin and Copenhagen, pas- 
teurization is very generally used. At one source in Berlin 
which supplies probably 75 or 80 per cent, of all the milk 
used, they have adopted pasteurization, and not pasteur- 
ization which we know in this city as commercial pasteur- 
ization, but what is scientifically known as pasteurization. 
They have had that in use for about three years. 

In Copenhagen perhaps longer, perhaps four or five 
years, pasteurization has been used for the milk supply of 
the city. There the pasteurization is probably not quite 
as complete as in Berlin. 

In reply to inquiry by mail in regard to some of the 
questions raised in the program under "Pasteurization" and 
as to the effect upon ordinary bacteria and disease germs of 
commercial pasteurization continued 30 seconds instead of 
the usual 15 seconds or less, answers by letter were sub- 
stantially as follows : 

Should pasteurization be made compulsory? Out of 
twenty-three there were twenty-one "No," one ''Yes, un- 
less the tuberculin test used twice yearly shows the herd 
to be free from tuberculosis" ; one *'Yes, if clean milk can- 
not be secured otherwise." 

Would it render inspection unnecessary? 

Twenty-three straight "No." 

Would it reduce need for inspection? 

One "Yes"; twenty straight "No"; one "Somewhat"; 
one "Possibly, not necessarily." 

What efifect is produced upon ordinary bacteria and 
disease germs by pasteurization at a temperature of 165 de- 
grees F. continued 30 seconds followed by rapid cooling? 

In reply to this only twelve replied specifically. 



EFFECT OF COMMERCIAL PASTEURIZATION 31 

These answers were received : Dr. Bartley : "Many 
killed, but not as satisfactory as longer exposure — does not 
kill tubercle bacilli." Dr. Ager : ''Most destroyed — not 
tubercle bacilli," ''not certain putrefactive organisms." Dr. 
Armstrong : "Would kill some, the more pathogenic bacteria 
and spores would resist such exposure." Prof. Cbn'n : 
"Many are killed — disease germs mostly, but not wholly — 
tuberculosis germs not necessarily destroyed." Dr. Free- 
man : "I know of no evidence that such temperature and 
time kills the pathogenic germs we fear in milk." Dr. 
Goler : "Kills some of the ordinary bacteria and delays sour- 
ing, but disease-producing organisms not materially afifect- 
ed." Dr. Harrington : "AH souring bacteria are killed ; the 
more important peptonizing bacteria are not all killed, and 
may continue multiplying and producing deleterious changes 
in the milk, which is apparently sweet and in good condi- 
tion." Dr. Harris: "Very little in 30 seconds." Dr. Heb- 
berd : "The growth of less resistant bacteria will be 
checked." Dr. Oertel : "Little or none." Dr. Park: "Kills 
90 per cent, of all the bacteria, 95 per cent, of typhoid and 
diphtheria — much smaller proportion of tubercle bacilli." 
Prof. Vulte : "Kills useful and harmless bacteria — does not 
materially injure disease bacteria." 

The Chairman: I will ask Dr. Goler 
Infants to open the discussion on "Infants Milk 

MUfc Depots." 

«po »♦ j^^^ Goler: Keeping as closely as pos- 

'Sible to the questions laid down in the 
program, I believe the first subject is "Should infant milk 
depots use pasteurized or clean milk?" 

I think I can best discuss that part of the question by 
telling something very briefly of Rochester's experience 
in the use of clean milk in its milk depots. 

We have about 200,000 people. Some ten years ago 
we began to use, after the manner of Mr. Straus, some 
infants milk depots with pasteurized milk at first, and we 
had such difficulty in getting clean milk, that after two or 
three years we thought we would devote our attention to a 
clean-milk supply. 



32 ROCHESTER S INFANT MILK DEPOTS 

Now, the plan at Rochester which we use is really quite 
a simple one. We have no farm; we own no cows. We 
have simply a traveling apparatus that altogether, taken 
all in one, is worth about a thousand dollars. The plant 
consists of a portable booth with a platform running out 
from it, and outside of tliat portable booth where the milk 
is bottled there is a temporary sink and running water, and 
sewer, and back of that a tent used for sterilizing cans and 
utensils and not milk, and still back of that a tent where a 
nurse has her being for the time that the milk station is 
running. 

This central station on the farm is used chiefly for the 
purpose, first, to furnish to sub-stations in the city a supply 
of clean milk, and second to act as an educational example 
to farmers in the surrounding country. 

When this plan was started it was the idea to take this 
portable plant from place to place, putting it down on one 
farm for one year, and on another farm for another year, 
and thus try to have what Maryland has carried out in a 
much larger way, a kind of portable educational example 
to the milk men. 

(Dr. Goler here exhibited several photographs.) 

Now, the milk is produced on the farm under cleanly 
conditions, and there is a nurse who superintends, with nec- 
essary assistants, the production and bottling of the milk. 
Then the milk is shipped already iced to a number of sub- 
stations; we have but four in our comparatively small city, 
and each one of these stations is attended by a trained nurse 
supplied with a table and refrigerators filled with ice and 
supplied with twine and paper, and the children are brought 
to her and she provides them with the necessary advice in 
the absence of advice from the physician, and with milk for 
the baby, and with a little booklet which is printed in several 
languages, and with which everybody is more or less fa- 
miliar. Now, the idea, as I said a moment ago, is to provide 
for the education of the farmers through the work upon the 
farm, and for the education of the mother from the sub- 
station. 

I think it is perfectly plain that such stations are desir- 
able, both the stations in the country, and these sub-stations 
in the city, for out from both of them must come a great 
deal of good. 



INFANTS MILK DEPOTS 33 

The question, ''Should private philanthropy support de- 
pots ?" I hardly know how to answer. It seems to me that 
it is the duty of the municipality to take care of its infants, 
the children and the adults — in fact, the people are practi- 
cally the only assets that a municipality has, and if it is not 
the duty of the municipality to take care of its people, then 
the municipality has no duty at all. 

The question of whether private philanthropy should 
support depots — it would probably seem better in a large 
city like this that the aid of private philanthropy should be 
sought, but that the aid of private philanthropy should en- 
tirely sustain the depots instead of the municipality, I don't 
believe at all. 

"How many depots would be required in New York 
City?" I am not familiar enough with the conditions to ad- 
vance an answer to that question. 

"Is Rochester experience applicable to New York City?" 
It seems to me that you are the best judges of that, but the 
educational work is the important work, it seems to me, at 
both ends, both in the stations and on the farm. We have 
sought to teach the farmer. (Dr. Goler here exhibits pho- 
tographs of farmers' apparatus, accompanied with explana- 
tory remarks.) 

Isn't it the duty of the city to provide this education? 
What we want more than anything else is education for the 
mother and education for the farmer. 

I always have a hesitation in mentioning the death rate. 
Figures can't lie, but liars can figure. That is an old story 
that we are all familar with, but we began this work in 
1897, and after a period of ten years, taking all the deaths 
from all causes, whether due to scarlet fever or to milk in- 
fection, our percentage of deaths under five years of age, 
from all causes, was 33 per cent. For the last ten years it 
has been 20 per cent, in round numbers, and it fell imme- 
diately just as soon as we began to establish this work. 
Along with this has come other work that I ought not to 
speak of in this connection, but that diminution began imme- 
diately and has continued ever since. 

A Voice: Will the gentleman tell us what the present 
death rate is? 



34 INFANTS MILK DEPOTS 

Df» Golen The present death rate from all causes is 
about 15 and a fraction. 

Dt* Ager: I am much interested in this subject because 
for the last three or four years I have had much to do with 
the milk in the Children's Aid Society of Brooklyn. If the 
first question means, should we distribute only pasteurized 
milk from infants milk depots, I think we should, for pas- 
teurized milk will keep longer. 

The Chairman: I would like to ask for information. 
One of the speakers a little while ago, if I understood him, 
said that pasteurized milk was more likely to be contam- 
inated afterward than unpasteurized. I understood the last 
speaker to say that one reason in favor of distributing pas- 
teurized milk only was that the people who took it had no 
proper facilities for taking care of it. 

Now, perhaps, I misunderstand the two statements, but 
they don't seem to me to exactly hang together. I would 
like to ask the Doctor what he has to say to that? 

Df^ Ag:er: In our experience, Mr. Chairman, for 
the first 24 hours the modified pasteurized milk will keep 
better than the unpasteurized milk. I have looked into that 
very carefully, and I have found that the certified milk that 
we get in Brooklyn will spoil more quickly under those con- 
ditions than the pasteurized milk. 

The Chairman: You mean spoil from changes oT 
temperature ? 

Dr, Agfer: Yes. 

The Chairman: But how about the effect of contami- 
nation under improper handling or unclean vessels ? 

Dr, Ag:er: That does not enter into the question of 
milk depots, because, as we distribute milk in Brooklyn and 
as they do in New York, the milk is ready for feeding. 

The Chairman: In feeding bottles? 



JUNIOR SEA BREEZE 35 

Dt* Ag:cn Yes. 

Df» Williams: I would like to mention something in 
regard to the educational part of the work. I think that all 
the doctors who practice among the poor people are agreed 
that the thing they need most of all is education. Dr. 
Goler has told us of the way this view was accepted in 
Rochester, and to a limited extent last summer it was ac- 
cepted in New York. 

At 65th street the Association has a summer camp known 
as ''J^i^^o^ Sea-breeze," established through the generosity 
of Mr. John D. Rockefeller. There the mothers were given 
lessons by physicians and nurses who were shown how to 
prepare the food for the children and how to take care of 
the babies. The thing I want to bring out is just this, that 
mothers did not have to be persuaded to come there; they 
came readily and gladly and most of them learned intelli- 
gently. 

I am sure that any campaign in the future in regard to 
education, if properly carried out, will be taken very readily 
by the mothers and will reduce the mortality more quickly 
than any other means. 

Df« Agcti I notice that the question of educational 
work comes in under this subject. We have tried various 
methods in Brooklyn. Our first year we had volunteer 
physicians connected with each depot. We had a card sys- 
tem. The name of every applicant for milk was put on the 
cards with various questions in regard to sanitary matters. 
These cards were distributed to the volunteer physicians 
and every case was visited by those physicians and statistics 
collected, and so far as possible instructions given to the 
mothers. We only used it that one year. 

Since then we have had paid nurses in connection with 
every station ; they visit every patient and instruct mothers 
in the best way of taking care of their children, not only in 
the preservation of the milk, but other sanitary matters. We 
find that the result is very satisfactory. Near the end of the 
summer we tried having conferences with the mothers in 
connection with some of the depots and this worked out 
with varying success, depending somewhat upon nationality. 



36 INFANTS MILK DEPOTS — TESTS 

Df. Holt: In the great need of some definite informa- 
tion in regard to exactly what the results were in infant 
feeding in tenement houses, the Rockefeller Institute and 
the Health Department made a few years ago a series oi 
observations upon infants in the tenements. They were 
published and are doubtless familiar to most of you here 
but it may not be out of place to bring a few of these facts 
again to your notice, showing what actually occurred in the 
tenement houses; what various forms of milk the people 
were using for infant feeding, and what the results were 
with those that were most used. 

The things chiefly used are: (1) condensed milk; (2) 
milk which was procured from the groceries, which was 
known by the people as "store milk" ; (3) to a much less de- 
gree, a fair grade of bottled milk ; (4) milk from the differ- 
ent distributing stations or milk depots — those of Mr. Straus 
and others connected with various dispensaries or diet 
kitchens. 

An attempt was made to secure continuous observations 
upon children fed in these diflferent ways. The different 
groups of children were followed up by physicians, who 
made regular weekly visits, for an average period of three 
months. Observations were made during a portion of two 
summers and for one winter season. The children were not 
selected, except that care was taken that all the infants were 
well at the time of beginning observations. 

In winter it was found that the kind of milk employed 
did not, to any important degree, afifect either the amount of 
illness or mortality in the infants. But in summer, it made 
an enormous difference. We found in the first place that, as 
was expected, the highest mortality and the greatest amount 
of illness occurred with the dirtiest milk, viz., that which 
was purchased at the corner grocery and in which the bac- 
teria ran up into the millions. That the next poorer results 
were obtained from condensed milk. We found that by far 
the best results of all were obtained from the milk from the 
milk depots. 

The figures are as follows : Grocery milk was the food 
of 79 infants who were observed during the summer. Of 



METHODS IN INFANTS MILK DEPOTS 37 

these, only 21 did well ; 23 did fairly ; 20 did badly, and 15 
died; in other words, good results in 56 per cent, of the 
cases, bad results in 44 per cent. In nearly all of these 
cases, the milk was heated in some way before feeding; 
usually, it was raised nearly to the boihng point. 

Condensed milk was the food of 70 infants observed dur- 
ing the summer. Of these, only 22 did well; 20 did fairly; 
14 did badly, and 14 died ; or 60 per cent, good results and 
40 per cent, bad results. 

Milk from the milk depots was the food of 145 infants 
observed during the summer. Of these, 84 did well ; 33 did 
fairly ; 24 did badly ; 4 died ; in other words, 81 per cent, of 
good results and 19 per cent, of bad results. 

There were 98 children observed during the summer 
who were fed upon bottled milk purchased by the consumer. 
Of these, 37 did well ; 27 did fairly ; 29 did badly ; 9 died ; 
in other words, there were 61 per cent, of good results and 
39 per cent, of bad results. 

In the above groups the condition of the infants at the 
time the observations were begun were, in the different 
groups, practically the same, and their surroundings were 
very similar. Care was taken to have these factors as nearly 
uniform as possible. 

It seemed to us that one of the greatest things in account- 
ing for this good result from the milk depot was, in the first 
place, that the mother got no more milk than she could use 
for the day ; secondly, that the milk was given in the bottles 
from which it was to be fed ; thirdly, there was no more than 
an amount proper for one feeding put in the bottles ; fourthly, 
some attempt was made to adapt the milk to the child's 
needs. Thus, the less that was left for the mother to do, 
and the more done by someone who intelligently compre- 
hended what the problem was, the more successful were 
the results. 

Although the numbers included in these investigations 
are not large, yet the accuracy of the observation and the 
long time these children were followed, make them of great 
value. 

Had the figures been ten times as great, I believe they 



38 FRENCH MILK DEPOTS 

would only have emphasized the statements made and the con- 
clusions reached by Dr. Park and myself at that time, as we 
analyzed the data collected by the various observers, which 
were, that at the present time the use of the milk from the 
milk depots gives better results in the tenements than any- 
thing else employed. Experience since tlien has, I believe, 
shown even more clearly the advantages among the very 
poor of having as much as possible of the selection, prepara- 
tion and handling of milk for infants done for them, leaving 
to mothers who have neither the time, the intelligence nor 
the proper facilities, the smallest amount of responsibility. 

To carelessness and ignorance in feeding are due almost 
as much illness among infants as to the quality of the milk 
supplied. Hence it is that education and instruction in all 
matters relating to the hygiene of infants are quite as im- 
portant to insure results as a good, clean milk. 



Dr. Nofthrup: There is no baby on earth so valuable 
to-day as the French baby. There is no example of such 
strenuous effort to reduce infant mortality, on this round 
globe, as in France. They have taken up the work there in 
a way that is only comparable to the concerted effort the 
Japanese made to wipe away the insult which the Christian 
nations gave them some fifteen years ago. 

France is now attempting to reduce the infant mortality 
on a scale never seen before! Among the things that are 
very instrumental in that line is a milk dispensary, to which 
they have given a very fanciful name, *'La Goutte de Lait." 
The different dispensaries are all known as Les Gouttes de 
Lait. I visited the largest one in Paris. I dare say no one 
in this room has taken the trouble to go to Belleville. One 
might as well, for pure sight-seeing interest, go to some of 
the humdrum districts of Brooklyn and take a long car- 
riage ride, get there, and see nothing after they get there. 
(Laughter.) It is the deadly dull mediocrity of laboring 
Paris. I would never have gone except that Dr. Variot was 
good enough to take me in his carriage. 

Now, the most striking thing in all that organized effort 
to reduce infant mortality and save those precious French 



FRENCH MILK DEPOTS 39 

babies, because they need them, is the effort to instruct the 
mother. They started out first with the dispensaries in con- 
nection with maternities for curing babies when they were 
sick. Dr. Dufour started out to do one more thing, to keep 
them from getting sick. By him the first Goutte de Lait 
was founded. 

I won't speak of the milk, because I fear it will open a 
discussion beside the mark. It is sterilized milk, in bottles, 
which comes from the Pyrenees Mountains a long journey 
back, in ice, and suits them, and the results are good. 

The interesting point is the great organized effort to in- 
struct the mothers. Those mothers are requested and urged 
and induced by every means to bring the baby once a week 
to La Goutte de Lait. It is a regular happy family, some- 
where about five hundred in the family and all there at once. 
It is extraordinary the effort that is made to instruct them. 
At the first consultation — ''Consultation of Nurselings," as 
the name is — the mother of the child is taken into a private 
room where the history is taken and its heredity and every- 
thing about it recorded. This is supposed to be a confidential 
interview, which will not take place again. Thereafter it is 
preferred that this woman shall be in the large salle in order 
that she may see other women having their babies weighed, 
hear the commicnts, and learn as much as possible. There 
is very healthy competition as to who shall have the healthiest 
baby and who shall gain the most, the whole constituting an 
organized central office for sending out information in all 
directions. 

More interesting and astonishing than all else is the in- 
terest and organized effort in France in educating all moth- 
ers of all babies as to how they can keep their babies from 
getting sick and reducing general infant mortality. 

I should think that that came in harmony with quite 
a number of things that are being said. The whole thing 
is, as I have explained, but the result of perfect unanimity 
and largely because it is organized effort to keep them free 
from sickness. 



Commissioner Darlington: Permit me to repeat what 
I have frequently said in public, and that is, that I am in 



40 STRAUS INFANTS MILK DEPOTS 

favor of depots for pasteurized milk for infants. We 
have often taken occasion to commend the work of the 
Straus depots. Undoubtedly it is a good work, as you have 
heard from Dr. Holt. As to whether or not this should be 
continued by the city of New York or by private philan- 
thropy, I am unable to say. I doubt if we could do the 
same as in Rochester and have a trained nurse at every 
one of these depots. I beheve there is, however, a great 
educational work possible in connection with such depots. 
I think that is the main work, that people should be edu- 
cated by circulars touching these matters, teaching the 
mothers how to take care of their babies. 

Dr. Holt has shown us the great difference between 
getting the milk from one of these central stations and 
having the mother at home handle it. The difference is 
very great indeed. 

I can only say as I commenced, that I am heartily in 
favor of depots for the modification and pasteurization of 
milk for infants. 

Dr. Green: (Representing Mr. Straus.) More than 
three-fourths of the time is devoted to talk, talk, talk to 
the women. The physician is explaining to the mothers 
every day what to do for their children. They are handed 
pamphlets in various languages. 

The Chair: Dr. Green, won't you state for the benefit 
of the assembly what your work is at the Straus station? 

Dr* Green: My work is first to see the milk is per- 
fectly received and handled, although there are others to 
look after that. My work is to see the mothers; to tell 
them how to take care of their children; what milk to give 
them; how much to give them; when to stop; when to 
change, so the children will receive a succession of milk, 
so the stomach is strengthened and they are able to take 
stronger milk when the time comes to take it. If left alone 
to themselves the mother would give a formula to a child 
a month old and give the same to a child of ten months. 
The work is to give them advice, tell them when to start 
and when to stop, etc. 



MODEL MILK SHOPS 41 

Professor Pearson: In view of all that has been said 
in regard to the benefits of pasteurized milk and education 
of mothers, I think it fair to ask if the benefits may not be 
due more to education than to the pasteurized m.ilk? 

It would be rather difficult for me to decide from what 
I have heard here whether the pasteurization of milk is 
advisable or not. Perhaps it is education that brings the 
good results. 

Dr. Green: The fact that these children thrive on the 
milk they receive must be due a great deal to the pasteur- 
ization. 

In reply by mail to the question from the program 
under Infants Milk Depots : ''Should they use pasteurized 
or clean raw milk?" nine advised "clean raw milk/' with- 
out qualification ; one "clean raw pasteurized" ; four "pas- 
teurized," without qualification ; four "pasteurized" "in sum- 
mer," "in warm weather," "properly in depots," "under 
present conditions" ; three "both," "but clean in either 
case," and "depending on season and condition of child.'^ 

The committee feels that it is desirable, for the purpose 
of having this report convey a correct impression, to say 
that many of those opposed to the general commercial pas- 
teurization of the city's milk supply are entirely well dis- 
posed to or strongly in favor of the true pasteurization of 
milk to be provided in feeding bottles for infants through 
infants milk depots or other agencies. 

The Chair: If there are no further re- 
Model marks on this subject we will pass to the 
Milk next, which is "Model Milk Shops." I will 
Shops* call upon Prof. R. A. Pearson to open the 
discussion on that subject. 

Professor Pearson: Owing to the lateness of the hour, 
and the fact that I think there is less difference of opinion 
on this than on any other subject. I shall make my sug- 
gestions very quickly. 

I think it would be best if the milk could be sold in 
company with very few other things. Certainly it would 



4^ GENERAL GROCERY STORES 

be fair to exclude from the store where milk is sold sub- 
stances that would contribute dirt or dust, or mold, and 
I think it should be possible to enforce such a regulation 
in New York City. 

If it were not possible, however, I would offer this as 
a suggestion, that a special booth be constructed in the 
grocery store where milk is to be sold, with absolutely 
nothing but milk to be allowed in it. The booth might be 
two and one-half feet square or three feet square, or two by 
five feet, and accommodate two or three cans, a little space 
enclosed so that the dirt and dust which is constantly being 
raised in these general grocery stores should not come in 
such close contact with the milk. 

Decidedly the law should discourage unsanitary places 
where milk is sold. It seems to me that present laws are 
sufficient, if their enforcement is rigid enough. I am not 
perfectly familiar with the laws governing the sale of milk 
in New York City. Generally it is better enforcement 
rather than new laws that is required. 

It seems to me that private capital or philanthropy can 
well be used for the establishment of milk shops, but I do 
not want to see it enter into this field to such an extent 
that it will take the place of business. If model shops can 
be established in a modern manner by private capital and 
the people who are in the business are incluced to follow this 
example it will be a most desirable solution. 

I do not think it is practicable to prohibit the use of 
cans. The great objection to the use of cans, even if they 
are properly cleaned in the first place, is that flies and dirt 
have opportunity to get into them, and the dipper which 
is constantly removed and replaced does much to con- 
taminate the milk. Other devices might be used; a can 
with a lid which would be open only when held open 
might be substituted, or a faucet at the lower end of the 
can could be used for drawing off the milk. Of course, 
it would be well if we could get rid of the cans, but I am 
considering the practical side of it. 

As to refrigeration of the milk, the present require- 
ments, it seems to me, are sufficient. I understand that 



MODEL MILK SHOPS 43 

the milk must be held at all times under 50 degrees. If it 
could be held at a still lower temperature it would be an 
improvement. I doubt, however, if this would be practic- 
able. 

Every establishment where milk is sold should have, 
and should be ready to show to the inspectors, at any time, 
apparatus for the sterilization of the utensils used in hand- 
ling the milk. It might be no more than a wash boiler, 
standing upon the stove and used for sterilizing milk 
utensils only. The utensils could be put into that and 
boiled for a length of time. It is not necessary to use 
steam. 

I do not think, Mr. Chariman, that these requirements 
would necessarily increase the price of milk. 

Mr, Clarence B. Lane: I should like to outline brief!}/ 
the system we have in Washington. Score cards have been 
in use some time for scoring dairy products, but I do not 
know that any attempt has been made to score city milk 
plants. We found it necessary to have some system to 
get at the exact conditions and point out the good and bad 
points and to show the managers of city milk plants and 
milk shops just where they stand. We wanted to give 
each plant a rating and point out where improvements were 
needed. 

We prepared in the Dairy Division a score card for this 
work and are now cooperating with the Board of Health 
in improving the milk supply of Washington. The plan 
is working out very satisfactorily so far, and I think it is 
going to be the means of improving the city milk plants 
and bringing them up to a high standard. A copy of the 
score card is on following pages. 

We find in almost every case that the manager is very 
willing to talk over the conditions and to have the in- 
spector point out his faults. The inspector is often asked 
to come again and rescore the dairy after the improve- 
ments are made. 

This seems to be a good way to cooperate with the milk 
dealers; to appeal to their pride and to bring about an 
improvement of the conditions under which milk is sold. 



44 

DIRECTIONS FOR SCORING. 



MILK ROOM. 



Location.— If not eonnectedby door with any other building, and surroundings are good. 
10; when connected with other rooms, such as kitchens, stables, etc.. make deduc- 
tions according to conditions. 
CoNSTEUCTioN.— If good Cement floor, and tight, smooth walls and ceiling, and good drain* 

age. allow lO ; deduct for cracked or decayed floors, imperfect wall and ceiling, etc. 
OlBanliness.— If perfectly clean thruout. allow 15; deduct for bad odors, unclean floor 

and walls, cobwebs, unnecessary articles stored in room, etc. 
Light and TENTiLATioN.~If window space is equivalent to 15 jt or more of the floor space, 

allow 5 : deduct i point iuv eyery 3^4 less than the above amount. 
Equipment: 

Arrangement— Allow 3 points for good arrangement ; If some of the equipment L=» out of 
doors or so placed thatTt can not be readily cleaned, make deductions according to 
circumstances. 
Condition.— It in good repair. allowTS points: make deductions for rusty. wom-oiit,_or 

damaged apparatus. 
CoiiMruction— 

Sanitary: If seams are smovth, and all parts can be readily cleaned, allow 2. 

Deduct for poor construction, from sanitary standpoint. 
Burahilitv: If made strong and of good ^laterial, allow 2. Deduct for light con- 
struction and poor material. 
CkanKness.— If perfectly clean, allow '5 )x)ints; make deductions according to amount of 
apparatus improperly cleaned. 

MILK. 

Handling.— If milk is promptly cooled to 50° F. or lower. allow.l2 points : or if pasteurized 
at a temperature of 149° F. or above and promptly cooled to 50° or lower, allow 12 
points. Deduct 1 point for every 2° above 50°. If milk is pasteurized imperfectly, 
deduct 6 points. If milk is improperly bottled or otherwise poorly handled, make 
deductions accordingly. 

Stobage — If tored at a temperature of 4£}° F. or below, allow 8 points. Deduct 1 point for 
every i. above 45°. 

SALES ROOM. 

Location.— If exterior surroundings are good and building is not connected with any 
other under undesirable conditions, allow 2 : for fair conditions allow 1 ; DOor condi- 
tions, 0. 

Constkuction.— If constructed of material that can be kept clean and sanitary, aUow 2 ; 
for fair construction allow l; poor construction, o. 

Equipment.— If well equipped with everything necessary for the trade, allow 2 ; fair equip- 
ment, 1 ; poor equipment, o. 

CLEANiiiNESs.— If perfectly clean, allow 4 points ; if conditions are good, 2: fair.l; poor.o. 

WAGONS. 

Genekal appearance.— If painted and in good repair, allow 2 points : for fair condition. 1 ; 
poor. 0. 

Protection of product.— If product is iced, allow 3 points ; well protected but not iced, i : 

no protection, o. 
Cleanliness.— If perfectly clean, allow 5 ; good. 3 ; fair, 2 ; poor, o. 



45 



UNITED STATES DEPARTMENT OF AGRICULTURE, 

BUREAU OF ANIMAL INDUSTRY, 
DAIRY DIVISION. 



SANITARY INSPECTION OF CITY MILK PLANTS. 

OAvner or manager: Trade name: ._ 

City: ^ -. Street and No. : ^. State:. 

(Milk, 

Number of wagons: 



Gallons sold daily :{ 

i Cream, 



Permit or license No.: 


Dfti 


e of inspection: , 190 






SCORE. 


REMARKS. 




Perfect. 


Allowed. 


MIUK ROOM. 


10 




















Construction- 
Floor (S) 


10 

15* 
10 

> 15 

,. 
1" 

10 






Walls and ceiling (3) 














tight and ventilation 






Equipment— 

Arrangpment 3) 






Constmction — 






Sanitary (2) 






Durability (2) 

Condition (3) ...... 















MILK. 










SALES ROOM. 

Location (fi) 




Construction (2) 






Eanipment(2) 










WAGONS. 










Cleanliness (5) 










Total 


lUJ 















Sanitary conditions are— Excellent: Good: 

Suggestions ty inspector: 



Fair: 



Poor: 



Signed ; 
D. D. 118.— 10-22-06-600. 



[OVBB.] 



Inspector, 



46 INSPECTION OF MILK SHOPS 

We expect soon to establish a standard score which prob- 
ably will be 70 or 75 points, and the city will insist that 
milk shops come up to this standard, so this is really a 
method of bringing the places where milk is handled and 
sold to a reasonable standard of cleanHness. 

The Chairman: Dr. Lane, won't you give us an in- 
dividual instance of the changes that have taken place in 
an establishment of your own city, in a model shop that 
you have in Washington? 

Mr. Lane: The principal changes that have taken place 
in the milk plants of our city have been largely in the 
sanitary conditions. Cleaner floors, cleaner walls, less 
cobwebs on the ceilings, less rubbish, etc. In many cases 
the buildings are poorly located and sometimes connected 
with horse stables, wagon sheds and kitchens. These arc 
the lines of improvement along which we have been 
working. 

The Chairman: To what extent have these conditions 
been complied with in Washington? 

Mr* Lane: We have just begun this work, sir, covering 
some twenty-five milk shops. 

The Chairman: Do they take readily to the suggested 
change? 

Mr* Lane: The managers of the milk plants have taken 
very readily to this system so far. They are given a copy 
of the score card when the inspector is through. In fact, 
the manager goes through the plant with the inspector in 
most cases and scores along with him. In some cases he 
is asked to score his own plant and frequently he scores it 
lower than the inspector himself. 

The Chairman: How long has it been in vogue? 

Mr* Lane: We have been at this work about three 
months. 

The Chairman: And, roughly speaking, how many 
shops have taken it up? 



SCORE CARDS 47 

Mr* Lane: We haven't finished the inspection as yet, 
but I would say that at least one-half have promised to 
make the improvements suggested, and some of them 
have already been rescored on application to the inspector 
and they have increased their scores at least twenty points 
in a few cases. 

I might mention briefly some of the ways they have 
improved. Occasionally you would find an ice-box that 
perhaps was constructed of wood and had stood in the 
room where the milk was handled for four or five years 
and begun to decay and occasionally the walls and ceiling 
would be coated with milk. Instances of this sort, of 
course, decrease the score very much, and by using plenty 
of white-wash, by improving the drainage and by putting 
in cement tanks instead of Vv^ooden ones they have been 
able to increase the score. Some of them have put in 
more light; better equipment; exchanged the old milk cans 
and pails for new ones, and in fact, made improvements all 
along the line. 

I might say that in some cases vvc liave found the 
salesroom has been in very close proximity to the living 
room, and on going to purchase milk a woman would 
come to the salesroom with a child in her arms and wait on 
the customer. These things are very objectionable, be- 
cause if there are any infectious disease in the house the 
customer might take it home. Our score card provides for 
a considerable reduction in the score where the salesroom 
is directly connected with the kitchen or som.e other part 
of the house. I don't know that this plan would work in 
New York. I merely suggested it as being used in Wash- 
ington. 



Df» Hunt: In New Jersey we have a work going on 
similar to that described by Mr. Lane. At the present time 
the creameries in New Jersey are under the supervision of 
the State Board of Health and licenses are issued by the 
board. We have found that the conditions in what are 
known as milk depots are often very serious. In several in- 
stances the managers of milk depots have been notified that 
they must come up to the requirements of the laws, and the 



48 NEW JERSEY LICENSE SYSTEM 

result has been in a few instances that the owner has decided 
to retire from business. We expect good results to follow 
the enforcement of this law. As yet no system of scoring 
dairies, as described by Dr. Lane, has been introduced. 

The Chairman: Perhaps Dr. Hunt will state briefly 
what the requirements of the law in New Jersey are? 

Dr. Hunt: An effort has been made for several years 
to get a satisfactory law in New Jersey for the control of 
creameries and dairies. The last legislature passed a cream- 
ery act which we consider very efficient. Under the provi- 
sions of this law creameries are required to come up to a 
certain standard, and the power is given to the State Board 
of Health to refuse to grant licenses to creameries which are 
not kept in a sanitary condition. An inspection of all the 
creameries in the State is now going on. The first section 
of the act referred to requires that creameries shall have 
cement floors, that a creamery building shall not be occupied 
as a dwelling, and that the milk shall be so handled that it 
shall be kept in a cleanly condition. The number of cream- 
eries in New Jersey, including wholesale depots in cities, is 
225. These are being inspected and when a favorable re- 
port is received upon any one of the creameries a license is 
issued. In case a license is issued to any creamery, and a 
reinspection shows that the premises are not in a satisfactory 
condition the license may be withdrawn, and a fine of two 
hundred dollars imposed. 

The Chairman: Does the law also regulate stores and 
shops from which the milk is sold? 

Dr. Hunt: The law originally was only intended to 
regulate creameries, but the interpretation which has been 
placed upon it by legal counsel is that the wholesale shops 
in cities are also included. Of course, no milk is shipped 
from any of the wholesale shops in cities in New Jersey to 
New York. Nearly all of the milk which is forwarded to 
New York is from the creameries. I might say in this con- 
nection that an arrangement has been made with the health 



GROCERY SALE RESTRICTED 49 

authorities in Philadelphia by which information in rela- 
tion to the condition of dairies in New Jersey, from which 
milk is shipped to Philadelphia, is forwarded to the chief of 
the bureau of health, and under his direction the milk from 
these dairies is excluded from that city. If upon reinspec- 
tion of the premises it is found that the owner has made the 
necessary improvements in the management of the dairy, 
and in its sanitary condition, this information is forwarded 
to the bureau of health, and the prohibition against the ad- 
mission of the milk into Philadelphia is removed. This ar- 
rangement has been going on for a considerable time, and 
the results have been very satisfactory. 

Df* Bartley: . It seems to me that these two first ques- 
tions in the program ought to be answered a little more 
definitely than they have been answered yet, and in a few 
words I should say this, that milk should not be allowed to be 
sold in an ordinary grocery store. That is the first one. It 
should not be sold in connection with other promiscuous mer- 
chandise. I believe the milk shop should be a special estab- 
lishment where milk is the main thing. The general grocery 
business should not be allowed to go with the milk store. In 
regard to a law to discourage other than model shops, that 
will be answered in that statement. I think if we should boil 
this whole thing down to just that, we would have something 
definite, because the average grocery store is certainly pro- 
ductive of a great deal of contamination, flies, cockroaches, 
dirt of all sorts get in the milk, as I have noticed hundreds 
of times in inspecting it. It is not a fit place and nobody 
should be allowed to sell milk without a properly constructed 
ice box or refrigerator. 

Mn Allen: You might be interested in a suggestion 
of Dr. Biggs. In speaking to me outside he regretted that 
he could not have said himself that he thought there was no 
reason why Dr. Lane's scheme should not be applied at once 
to the dairies as well as the milk shops, and I hope this eve- 
ning we can return to the subject and this question of raising 
the standard of the milk shop and dairy by just such a score 
card scheme as that suggested by Dr. Lane. 



50 resolutions: afternoon session 

Mr, Lane: I would say that we have, after making 
many changes, settled on this form of a score card which 
we believe is practical because we find it works. We have 
used it in scoring five or six hundred dairies, and it has given 
most excellent results. 

Dr, Freeman: I would like to suggest that these score 
cards are in use in other places. Dr. Park has used one for 
the County Medical Society dairies, and Professor Pearson 
has used one he has prepared in rating New York State 
dairies. They are not applied to shops, but to farms. 

The following resolutions were unanimously adopted : 

Resolved, That it is the sense of this conference, 

1. That the sale of skim milk should be permitted, but 
not for consumption by infants, and not in retail stores 
where whole milk is sold. 

2. That pasteurization should not be made compulsory ; 
that commercial pasteurization has some value, but not the 
same as true pasteurization. 

3. That infants milk depots should use both raw milk 
and pasteurized milk, but that all milk used shall be clean ; 
that it is questionable whether municipal depots are desir- 
able ; that much educational work is possible in connection 
with milk depots. It should be directed to the instruction 
of mothers and other persons having care of infants in the 
proper method of feeding infants and the importance of 
cleanliness in their care and feeding. 

EVENING SESSION 8 P. M. 

The Chairman: Gentlemen, we come 

Model now to the subject v/hich was under discus- 

Mllk Shops sion when we adjourned, namely. Model 

Continued. Milk Shops. We have discussed several of 

the questions under that head, and come 

now to the question of the sterilization of bottles. 

Health Commissioner Greene, of Buffalo: I believe 
the time is coming when we will have to discard milk bottles 
and get something that will perhaps do better. I only 
speak from experience locally, and that is that the house- 



TEMPERATURE IN MILK SHOPS 51 

wife sends the children to the grocery with the milk bottle 
to get molasses and vinegar and kerosene oil in it, and that 
milk bottle is given to the milk man when he comes in ex- 
change. I have had milk bottles used to send urine to my 
office for examination and a physician in the city of Buffalo 
who recently died told a lady from whom it was necessarv 
to get some fecal matter to use a milk bottle for it, and I 
might say also that in going to make a visit someone stole it. 
Something must be done whereby the use of milk bottles 
for such purposes can be stopped. 

Mf. Allen: I wish Dr. Lane would tell us what his de- 
partment has been doing for Cleveland ; it might be a help 
to us. 

Mf» Lane: In regard to Cleveland, that work was in 
connection with dairy farms, and I understand that that 
subject will come up with the next topic. 

The Chaifman: No one has yet touched on the subject 
of what provision can be demanded for proper refrigera- 
tion, for receiving milk before business hours when deliv- 
ered from stations. 

A Member: Wagons delivering in the early morning 
at stores not yet open leave cans outside, unprotected from 
heat in summer, and from warm rains. The milk grows 
warm and bacteria flourish. It would not be a hardship to 
require that inexpensive folding boxes be provided to which 
drivers could have keys. In this way with very little ice a 
serious danger would be avoided. 

The Chairman: I would like to ask Dr. Bensel how 
completely the regulations of the Health Department as to 
temperature are carried out? 

Dr* Bensel: It has been found to be practicable to see 
that the milk is kept at a proper temperature. Constant in- 
spections are being made and temperatures are being taken 
to see whether this regulation is lived up to. Milk found 
below the required temperature is condemned and dumped 
down the sewer, and the consequence is that it is lived up to 



52 STERILIZATION IN MILK SHOPS 

fairly well. Of course, during the winter months, there is 
no trouble. In the summer the temperature of milk may be 
higher and we have to destroy a considerable quantity. 

In the model milk shop there is no reason why a box 
should not be provided with ice where the cans can be kept 
covered and away from the dust of the street and the shop. 

The Chairman; Wliat would be your answer as to 
what provision can be demanded for proper refrigeration? 

Df» BenscI: Proper refrigeration is demanded and is 
very properly kept up. 

The Chairman: What is the temperature at which 
milk must be kept? 

Dr. Benselt It must be less than 50 degrees. 

Mr* Opdycke: How near the purchaser does your in- 
spection come? How near the time when milk is sold do 
your people examine it? 

Dr» Benseh The examinations are usually made very 
early in the morning, because in many stores the milk is sold 
very soon after it is received. That is very generally the 
case for small stores. Examinations may be made wherever 
we find milk, sometimes in a store, sometimes in a wagon on 
the street and sometimes in a railroad yard. 

Mr* Opdycke: Are inspections made in the afternoon 
when this milk is being dealt out by the dipperful for fam- 
ilies ? 

Dr* Benseh There is scarcely an hour by day or night 
when these inspections have not been made. 

The Chairman: ; Now, what provision should be made 
for the sterilization of bottles and utensils? That has been 
touched upon more or less in the discussion, but I don't 
know there has been any general expression of opinion in 
regard to that, and it is a pretty important branch of the 
subject. 

Dr* Holt: It seems to be clear that milk bottles are 



STERILIZATION IN MILK SHOPS 53 

often the means of spreading disease, and therefore no dairy 
or creamery ought to be permitted to sell milk in bottles or 
to distribute it in bottles which has not the proper facilities 
for cleansing and sterilizing bottles. 

I think some of us may remember what the conditions 
were in Philadelphia a few years ago when things were so 
bad that an ordinance was asked for to prohibit milk being 
sold in bottles in the city of Philadelphia. It was found 
that men would go into a house and get empty milk bottles, 
fill them from their cans on the wagon and deliver them to 
the next customer. 

While all agree, I think, that the transportation and sale 
in bottles is the best method, we must see to it that the bot- 
tles are clean; proper cleansing of bottles is impossible un- 
less the dairies are provided with some means of sterilizing 
the bottles. That would seem to be a regulation not diffi- 
cult to enforce, i. e., that no milk should be sold in bottles 
from any creamery that has not the proper sterilizing ap- 
paratus for its bottles. 

In that way the carrying of typhoid, scarlet fever and 
diphtheria by this means could be prevented. We all know 
how easily this may occur from milk bottles which have 
stood in sick rooms. 

Commissionef Greene: When the dealer sends the 
cans back to the dairy in a very filthy condition, the ques- 
tion arises who should clean those cans and should the city 
dealer who handles those cans be permitted to put refuse in 
those cans and yet hold the dealer in the country responsible ? 
Or should the man in the country who empties the can be 
obliged to clean them and send them back? 

Dr» Goler: I think most of us agree to the importance 
of sterilization. The only disagreement might be as to the 
cost of a sterilizer. I think one can be made out of a plank 
and galvanized iron which will stand the pressure of eight 
or nine pounds, and can be made for three or four dollars at 
any rate. 

Dn Park: I don't think we want to demand absolute 
sterilization. What we want to be sure of is that a bottle is 
clean and all disease germs are killed. I don't believe it is 



54 STERILIZATION IN MILK SHOPS 

necessary to have steam at more than the ordinary pres- 
sure. 

Dn Golen Our sterilizer and similar steriHzers have 
been used for years. 

Dr. Coit: It seems to me this is a very important ques- 
tion that Dr. Holt has answered, first in that there should 
be some means by which all bottles used for milk containers 
should be steriHzed. 

Now, I am willing to take the lower grade of sterilizer 
for a general supply of milk, and not require an ex- 
pensive apparatus that is necessary to cause a temperature 
pressure of several pounds. I think that five pounds 
pressure would cause 225 F. For the milk that comes as 
''certified milk" and inspected milk we should have the 
highest kind of requirements and results, but with the gen- 
eral supply it never can be accomplished. Of course, it is 
impossible for us to expect these dairymen to change to 
this apparatus. I should think it would be fully sufficient 
if the Holland house-wife's method was employed in the 
dairy to keep dirt out. I should say that a sufficient steril- 
ization would be a man who knows how to get things clean 
on the Holland house-wife's method, by rinsing the bottles 
with something that would disintegrate the fat by washing 
it with soap or soap powder to get the milk out. If any 
remains they rinse first in cold, clean water, another clean 
water and another clean water. They should then be 
rinsed in water as hot as the hands will bear. That is a 
sterilizer; that man is a sterilizer and it is all we hope for 
from a majority of the milk producers. 

The ideal sterilizer would be one that would accommo- 
date four or five hundred bottles, railroaded in on a truck 
and sealed hermetically so that the pressure would be at- 
tained and the temperature acquired. It is necessary to 
raise the temperature to two or three hundred degrees F. 
for several minutes, and it seems to me the most important 
thing is to remove the disease germs. The few that 
remain won't do very much harm, but it is necessary that 
some requirement should be established by which these 
bottles may be sterilized, especially those coming back 



MILK SHOP ATTENDANTS 55 

from sources of contamination and contagion and in any 
supply of any magnitude there are bottles every day 
coming from scarlet fever or diphtheria or typhoid or tu- 
berculosis. These bottles ought to go through a special 
method of cleanHness or vigilance that would make them 
hygienically germ free. 

The Chairman: What provision shall be made for 
steriHzation of utensils and bottles under the head of the 
milk shop? 

Dr» Bartley: It seems to me that some protection 
ought to be thrown around the milk shop if they are to 
be allowed to fill milk in those shops into bottles. If these 
shops receive their milk in cans and then fill it into bot- 
tles, then they ought to provide a sterilizer. If they receive 
their milk in bottles then no steriHzer is needed. They can 
simply wash the bottles out as the housewife usually does, 
as clean as possible, and send them back to the creamery, 
the sterilizing to be done there. It seems to me that answers 
that question. 

The Chairman: What provision ought to be made re- 
garding the dress and care of the person of the attendants 
in the model milk shops ? 

Dr, Benseh The dress of an attendant at a model milk 
shop should be of washable material and should be clean. 

Dr. Armstrong:: In regard to the question of sterilizing 
bottles, instead of the expensive apparatus, a plan that 
would be applicable in the milk shop would be that which 
the surgeon uses in sterilizing his instruments, by boiHng. 
This could be done in a wash boiler, which is not an ex- 
pensive apparatus. 

Professor Pearson: It seems to me that the man who 
runs the shop ought not to be obliged to maintain a large 
plant to sterilize the cans. The casein should be removed 
at once by rinsing, and the cans may then be returned to 
the larger establishment where the cleaning should be as 
thorough as required. 



56 resolutions: milk shops 

The following resolutions were thereupon adopted : 
That nothing should be sold in connection with milk 
except other dairy products and sealed-package goods. 
Where milk is sold in grocery stores separate booths 
should be provided in which the milk is kept apart from 
other articles dealt in. It is not practicable to prohibit the 
use of cans; also the milk should be required to be kept at a 
temperature below 50 degrees Fahrenheit; all bottles 
should be cleansed and exposed to a boiling temperature 
for a sufficient length of time to destroy all pathogenic 
germs, and that the natural place would be at the creamery 
where they are refilled. 

That in model shops provision should be made for 
sterilizing utensils at least to the degree of boiling them 
daily. That the attendants should wear washable white 
suits both for cleanHness and for the moral effect upon 
those purchasing milk. 

The Chairman: We will pass now to 
Inspection. the subject of INSPECTION. Mr. Lane 
began this afternoon and I think he can 
now continue with considerable profit to us. 

Mr. Lane: Mr. Chairman, while inspection is important 
in securing a clean milk supply for any city, it is not all. 
Combined with inspection it is certainly necessary to have 
a campaign of education, not only among producers but 
consumers as well. 

New York City is not very different from a great many 
other cities. You have a good system of inspection but the 
trouble has been you have not had the money and you 
have not had the number of inspectors to carry the work 
far enough. What are fourteen inspectors among some- 
thing like 30,000 dairies ? As I understand it, your work in 
the past has largely been the inspection of creameries, and 
now it seems to me you have just begun the most import- 
ant part of the work, by going back to the dairy farmer and 
getting in close touch with him, not only by enforcement 
of police regulations but by moral suasion and education. 
It is clearly evident that only slow progress can be made 



DAIRY INSPECTION SCORE CARDS 57 

in improving dairies with so few inspectors. If a sufficient 
number of inspectors could be placed in the field to report 
conditions and close up dirty dairies until they were put in 
proper condition, it would go a long way toward securin<; 
a clean milk supply. One small city in your State that has 
had sufficient inspection has accomplished this, and no 
dairy that has not been approved by the Board of Health 
can sell milk within its limits. 

I have looked over your method of inspection, which I 
think is as good as that in any other city tliat has come to 
my notice. It provides for a report on the various con- 
ditions found in the dairy which is sent to the Board of 
Health office. I think the system of inspection, however, 
should go further than this and give the dairies a definite 
rating on some basis so that they can be classified and 
their condition readily compared from time to time when 
new inspections are made. With the present system it is 
not an easy matter to do this. 

Now, the Department of Agriculture in looking about 
for a way to assist the Boards of Health has decided that 
the very best way to go at it is through the score card as 
a basis, and as I said before, this score-card idea is not a 
new thing. My friend. Professor Pearson, was one of the 
pioneers in introducing the score card a few years ago, 
and since that time several others have appeared. Some, I 
believe, give too many points to the cow; this has been 
particularly true of veterinarians. Naturally the individu- 
ality of the man preparing the score card would be shown 
in the arrangement of the points. After the experience of 
scoring over one thousand dairies we have prepared a card 
which we think is practical and it has been adopted by the 
Board of Health in several cities. In Washington we are 
cooperating with the Board of Health and have scored 
over three hundred dairies. 

I don't know as I need to go into the details of this 
score card. It is divided into five sections. The cows arc 
given 20 points; the stables 25; the milk-house 20; the 
milkers and milking 15, and the handling of the milk 20, 
making a total of 100. 



58 

DIRECTIONS FOR SCORING. 



-^ cows. Part«c( 

•eow. 

Condition and healthfolness.— Deduct 2 points if in poor fiesh< and 8 points It not 

tuberculin-tested— -^ - - lo 

Cleanliness.— Clean. 6; good, i; fair, 2; bad. 6 

Wateb supply.— If clean and unpoUutedL 6: fair. 3; otherwise. 0.. s 

STABLES. 

CoNBTBUOTioN.—'For cement floor (o)* in good condition allow 2 points; fair. 1; poor. 0; 

wood floor (6) or other material in good condiuon. l; fair. *<; poor, o; good tie (c). 1: 

good manger (d). l; box stalUe), i — - 6 

Cleanliness.— If thoroly clean, including floor (a), windows (6), and ceilings (c), 5 ; good. 4 ; 

medium, 3; fair. 2; poor. 1: bad. _ ,.„. o 

Light.- Four square feet of glass per cow. 5 ; 1 point off for each 20 per cent less than 4 

square feet per cow ■. 5 

Ventilation.— Good ventilating system, 4; fair. 3; poor. 2; bad, o 4 

Cubic space peb cow.— If 500 cubic feet or over per cow, 3 ; less than 500 and over 400, 2 ; less 

than 400 and over 300.1; less than 300. O 3 

Removal op manure.— Hauled to field daily, 2 ; removed at least 80 feet from stable, l ; 

otherwise, ^ a 

Stable tabd.— In good condition (a). K; well drained {&), K; otherwise, o ., i 

MILK HOUSE. 

CoNSTBUCTiON.- Tight, sound floor, and not connected with any other building (a), well 
lighted (b), well ventilated (c), 2; (d) if connected with another building under good 
conditions,!; otherwise,0; (e) tf no milk house, _ _ 2 

Equipment.— Hot water for cleaning utensils (a), l; cooler (6), i; proper palls (c) and 
strainers (d) used for no other purposes, 1 , 3 

Cleanliness.— Interior clean. 5; good condition. 4; medium. 3; fair. 2; poor, l; bad. 6 

Cabe and cleanliness op utensils.- Clean (o). 3 ; kept in milk house or suitable outside 
rack (6). 2; otherwise, » 5 

Wateb supplt.— If pure and clean running water. 6 ; pure and clean still water. 3 ; other- 
wise, ,.-.....„ 5 

MILKING. 
Attendants.— Healthy » , 5 

Cleanliness of milking.— Clean milking suits, milking with clean dry hands, and atten- 
tion to cleanliness of udder and teats while milking, 10 ; no special suits, but otherwise 
clean (a), 7; deduct i points for uncleanly teats (6) and udder (c) and 3 points for un- 
cleanly hands (d) _ 10 

HANDLING THE MILK. 

Pbompt and efficient cooling.— If prompt (a). 6 ; efficient (6). if 60° F. or under, 5 ; over 
60° and not over 65°. 4; over 65° and not over 60°, 3; over C0°, O; if neither prompt nor 
efficient.©'. _ ^___ lo 

Stoeino at low tempebatube.— If 60° F. or under. 6; over 60° and not over 65°. 4; over 
65° and not over 60°, 3; over 60°, i . , 5 

Pbotection during tbanspoetation to mabkkt.— If thoroly protected (iced), 5; good 
protection. 4; partly protected. 2; otherwise, o 5 

100 

SCORE. 

If total score is 90 or above and each division 855^ perfect or ever, the dairy is Excellent 

(entitled to registry). 
If total score is 80 or above and each division 76 jf perfect or over, the dairy is Good. 
If total score is 70 or above and each division 65 it perfect or over, the dairy is Faie. 
If total score is below 70 and any division is below 65^ perfect, the dairy is Poob. 

♦ The letUri a, b, c, etc., should be entered on score card to show condition c( dairy, and when io cntereJ 
should always indicate a deficiency. 



59 



I>. ». 113—9-27-06^5,000. 

UNITED STATES DEPARTMENT OF AGRICULTURE, 

BUREAU OF ANIMAL INDUSTRY, 

DAIRY DIVISION. 



SANITARY INSPECTION OF DAIRIES. 

Owner or lessee of farm : ..- 

Towu: - Stale: 

Total No. of COWS: No. milking:. Vinarts of milk produced daily: 

Is product sold at wholesale or retail ? „. 

If shipped to dealer give name and address : .. ..„, 



Penait No. Ba 


te of insj 


ectioH : 


190 








600RE. 


KEMARKS. 




Pebfect. ] Allowjd. 


C0W3. 

Conaitl(m(2) — 

Health (8) 


5 

6-20 

5 
5 
5 

[ 7 
J 3-25 

[ 5 

5 
6 

5-20 

5 
10-15 

I 10 

5 
5-20 










Cleanliness > 












STABLES. 












Lighl _ ^-. 
















KenloTai of manure (2) 












MILK>HOUSE. 

Construction (2) , 

Pnninmpnt i?.t 










Cleanliness 












Water supply (Temp. -° F.). 

MILKERS AND MILKINQ. 




- ~ 








HANDLING THE MILK. 

Prompt ar.d efQcicnt cooling 

(Temperature of milk: °F.) 

Storing at a low temperature 

Frotection daring transportation - 






"" 







— - 








100 














Sanitary conditions are— Excellent: Oood: 

Suggestions by inspector; _ 



Fair: Poor: 



Signed ; 



lOTBB.) 



Jiis/feetor. 



60 DAIRY INSPECTION SCORE CARDS 

We have carefully worked out a system of directions for 
scoring so that different inspectors working on the same 
dairy ought to be able to score within five points of each 
other, and very often they get the same. I have copies of 
this card with me, and will be glad to explain it more fully 
to anyone after the meeting. 

In the 200 dairies scored around Washington, the cows 
averaged 11 points where 20 is perfection, or 55 per cent, 
of what they ought to; the stables scored 8 points, against 
25, or only 35 per cent, of what they ought to score. You 
see that is where thev fall down. The cleanliness, sanitary 
condition, construction of the floors and mangers were 
generally in bad condition. The milk-houses only scored 
12, on a basis of 20 for perfect, or 23 per cent, of what they 
should score; the milking scored 68 per cent, perfect, and 
the handling 37 per cent, perfect. Here again is where 
the condition of the dairies is often very bad. The dairymen, 
as a rule, do not properly handle the milk, cool and store it, 
and that is the reason why we find so many bacteria. Out 
of the 200 dairies the average score was but 55.5 on a basis 
of 100, so you see there is a good deal of missionary work 
to do. Conditions may be better in your State of New 
York. In another city, where we are cooperating with 
the Board of Health, 700 dairies have been scored, the 
average score is about 45 per cent. I might give some 
other data, but I think this is enough to show the general 
plan of the work. 

One of the great advantages of the score card is it 
shows at a glance just how every dairy stands. It gives 
them a definite rating. With the inspection in most of the 
cities, the inspector reports the condition of the dairies 
by answering fifteen or twenty questions, but it is very 
difficult to tell at a glance the standing of the dairy, 
whereas with the score card the condition of all parts of the 
dairy are readily seen. Another advantage is the assistance 
it gives the farmer to improve. You know there are lots 
of farmers who would be glad to improve their dairies if 
they knew exactly how, but they don't know how. 

The following letters are from dairymen who have had 
their dairies scored: 



INSPECTION — FREQUENCY 61 

''Dear Sir — It gave me great pleasure to meet your 
dairy inspector. He called at our farm and thoroughly 
scored our dairy, giving us 75 per cent, and showing, or 
pointing out to us, where we might score 100 per cent, 
with a few improvements, the fact we appreciated very 
much. I am just writing these few lines to show our ap- 
preciation of the valuable work that you are accomphshing 
for the benefit of the pubHc health as weU as the welfare 
of the dairymen at large. The visit of the inspector done 
us a world of good, pointing out our defects in the dairy. 

''Wishing your department the hearty cooperation of 
all the dairymen, I am. Yours sincerely, 

-(Signed) , 

"Manasrer for ." 



"My Dear Sir — I want to thank you personally for your 
visit to our farm this week. It has inspired me with 
renewed life and vigor. I shall not wait until the new year 
to make new resolves and promises but begin right now. 
I know I shall never reach my own ideals even, but I have 
made up my mind to try. No matter what the motive is 
in the Department of Agriculture in sending out such in- 
spectors, it cannot fail in my judgment to do immense 
good. 

"I want you to come around again next year, and if I 
am not entitled to be marked up at least 20 points, I will 
promise you to go out of the business, as I ought to. 

" Very truly yours, 

"(Signed) ." 

These are samples of the letters we are receiving from 
dairymen and show that they appreciate the work. 

Now, one of the questions I notice is with reference 
to how many inspectors it would take to clean up the milk 
supply of New York City. On the basis of the work we 
have already done it seems to me that one inspector should 
cover from 400 to 500 dairies in the field. This would give 
him an average of eight to ten dairies daily, when working 
twenty-five days in the month. Of course, it is understood 



62 INSPECTION OF DAIRIES 

that the inspector has no other duties. On this basis it 
would require sixty to 75 inspectors to cover the 30,000 
dairies and give them an inspection every two months. 
Perhaps conditions here are a Httle different than in 
Washington. 

We are going a Uttle farther in this matter of scoring 
dairies, and we have estabHshed a registry for every dairy 
that scores 90 points or over wherever found. This na- 
tional registration will be an incentive to dairymen to bring 
their dairies up to a high standard. Of course, it will be 
more or less of an advertisement to the dairymen who are 
doing well and trying to do what is right, but they ought to 
be advertised. After we have covered the 900 dairies around 
Washington we expect to publish in the local papers the 
names of all dairies that score over 70 points. A dairy 
that scores over 70 we consider fair. Publishing the names 
gives the consumer an opportunity to know just where good 
milk can be secured and it will encourage the producer who 
is trying to produce clean milk to keep on with the good 
work. 

I have mentioned the work we are doing outside of 
Washington. In the city referred to where over 700 dairies 
have been scored they have placed the standard score at 30 
to start with. While this seems ridiculously low, they 
find a great many dairies to cut off, even at 30, and they 
will raise that score to 50 or 60, or until they secure good 
milk. It wouldn't do to insist on 70 at first, but the Health 
Officer has written me two or three times that the method 
was working out all right, and it is only a question of time 
when they will have clean milk for the entire city. 

The Department of Agriculture will be glad to co- 
operate with any city in this work and give any assistance 
possible. 

Df, Bensel: Under the subject of inspection there are 
four catagorical questions that are asked, but before an- 
swering them as I think they should be answered I am go- 
ing to say a little bit about what New York City has done 
for milk; what it is going to do at once, and what it pro- 
poses to do in the future. 



INSPECTION — SEVEN LINKS 63 

I cannot talk very long, but I can show some of the re- 
sults of our inspection. Milk from the time it is produced 
until it actually enters the mouth of the consumer passes 
through a chain of about seven links : the dairy ; transporta- 
tion from the dairy to the creamery ; the creamery ; trans- 
portation from the creamery to the city, i e., the car trans- 
portation ; transportation from the railroad platform to the 
retail store ; the household where the milk is kept for con- 
sumption. 

As to transportation from the dairy to the creamery, 
and from the platform of the railroad to the retail store in 
the wholesaler's wagon, and the care of milk in the house- 
hold, these have been taken up and considered somewhat, 
but as yet have not been carefully worked out. Those three 
have been held to be less important primarily than the other 
four, and, of course, they have had to wait their turn in the 
work of the Department. 

In regard to the dairy. Prior to June, 1906, practically 
no work had been done by the City of New York in the 
dairies at all. Since June, 1906, 4,300 inspections of dairies 
have been made. Reports have been made covering recom- 
mendations and saying what should be done. Last week 
536 inspections were made. That 536 shows very fairly 
well what 14 men can do. There was some statement as to 
14 men not being able to do very much, but they can do 
536, and the 14 men alone could probably cover the whole 
milk supply, so far as the dairy is concerned, in less than a 
year. I don't mean that 14 are enough. They are not ; but 
they do a large amount of Vv'ork. 

I want to show here some conditions of the dairies : 
Those pictures (passing pictures about) show definitely the 
conditions of filth which are found in some of the dairies. 
It shows how very necessary it is to begin work where the 
milk is produced and how absolutely absurd it is to suppose 
that pasteurization will be a cure for such conditions as are 
represented in those pictures. There is no question but 
what milk produced from such stables as that (exhibiting 
picture) is in a condition similar to that of a can of milk in 
which a handful of manure is placed. That cannot be cured 
by pasteurization, but requires attention at the source. 



64 INSPECTION OF CREAMERIES 

Now, in the inspection of creameries, up to the present 
time, since the creameries were first taken up, we have 
made 2,100 inspections. That means that every creamery 
has been gone over two or three times at least. The cream- 
eries have been placed on a map in this way (exhibiting 
large map of New York State). Each one of these pins 
represents a situation of a creamery. The color of the pin 
represents the condition of the creamery now and when 
first found. On close examination a few pins will be found 
white in color. Those mean found at first in good condi- 
tion and needed no change. They are very, very few, and 
hardly discernible at the first glance. The green pins are pins 
showing dairies found in bad condition, but have been put in 
good condition, and the red pins are the creameries which 
were in bad condition and, so far as our knowledge goes, at 
the present time are still in bad condition. In 1906 we have 
made 946 inspections of creameries. We have gone all over 
them, as you see, up to the present time. Last week 105 
creameries were examined. 

I have some pictures here which will show conditions 
before and after inspection in these creameries. The im- 
proved conditions which we have produced I think are far 
more interesting than the conditions originally found. (Ex- 
hibiting pictures.) It will be seen in these pictures that 
improper floors and drainage were present and how they 
were cleaned up and put in proper condition after a subse- 
quent inspection. 

In the transportation of the milk from the country to 
the city, a great deal must be required. Some milk comes 
from over 400 miles away from New York. Consequently 
it is on the train for a long time. Effective refrigeration 
on the train is absolutely essential and the cars have been 
provided by almost all the railroads with proper refrigera- 
tion, double walls, proper receptacles for ice, and the milk 
has been kept in a very fair condition, keeping it at a tem- 
perature always of 50 degrees. The interior of a car is 
shown very plainly by this picture. (Exhibits picture.) 
The receptacles for the ice, the double-walled car and ice 
on each of the cans work very well in keeping the tempera- 
ture down in transportation. 



INSPECTION — TRANSPORTATION 65 

Concerning the fifth link in the chain of the milk, we 
come to the transportation from the railroad platform to 
the retail store in the wholesaler's wagon. This is a sub- 
ject which the Department has taken up, and it seems wise 
to require that those wagons shall be closed wagons with 
some provisions made for icing and keeping down the tem- 
perature during that time. I think that wall take care of 
that link. 

In regard to the retail store, the store where the milk 
is sold, we have many regulations which tend to protect the 
milk. We require that milk shall be kept in boxes, refriger- 
ated. We require that the box shall be covered. I don't 
mean to say for a moment that the boxes are covered al- 
ways or that the milk is always refrigerated. We require 
that no living apartment sh?ll be in connection with the 
place where the milk is sold and that the milk shall be han- 
dled and kept in a cleanly v/ay. 

During the present year, up to the present time, we 
already have made inspections of 110,000 in number of 
milk stores. That means, of course, that milk stores have 
been covered at least each month more than once up to 
the present time. 

Now, in regard to the questions asked here. In the first 
place, *Ts it practicable by inspection alone to secure a 
clean milk supply?" I would say, yes, it is absolutely pos- 
sible, perhaps not now, but after a time. If we keep our 
milk at a temperature of 50 degrees from the time when it 
is produced through the various transportations to the time 
it reaches the consumer, and educate the consumer to keep 
that milk cold while in his possession, I think there wall be 
no trouble in having clean milk by inspection alone. That 
doesn't mean in a city of this size that we shall have every 
drop of milk in a cleanly condition. 

In the second place, ''Will it protect against more dan- 
gerous forms of infection?" If followed up in that way, it 
must. 

As to the specific point of how many inspectors New 
York City needs wathin the city. Within the city we have 
at present, I think, a sufficient number of inspectors to look 



66 BACTERIAL COUNT 

after the work in the city. So far as the country is con- 
cerned, 'we have nowhere near enough inspectors. We 
have 14 at present, and the estimate which Dr. Lane made 
is very close to our own. We certainly should not expect 
to do very good work with less than 80 inspectors outside 
of the city. I think Dr. Lane's number is less than mine, 
because he didn't think of the number of miles our inspec- 
tors would have to travel. 

Now, there have been a number of other questions 
asked. How far is it possible to estimate the success of a 
campaign for clean milk by systematic bacterial inspection? 
It seems to me that if systematic bacterial tests are made of 
milk that has not been subject to a pasteurizing process, that 
it will give us absolute proof as to whether there is a suc- 
cess in the campaign or not. Of course, we can't take milk 
that has been filthy, pasteurize it and count the bacteria, and 
say that a low count proves that the milk was all right. In 
order to obtain a fair basis for comparing one year with 
another, how many samples in proportion to the dairy milk 
supply of a city is it necessary to examine, and what pro- 
portion should be taken in the summer? I think that most 
of the work of that kind should be done in the summer; 
that all we need is a few samples in the winter just to see 
whether the winter temperatures are keeping down the bac- 
terial count. I think it is immaterial to say what propor- 
tion we should examine ; simply a few samples a week taken 
at different places at different times would give us a very 
good line upon how the milk is running. 

To what extent is average cleanliness a fair criterion? 
Is it usually more important to see that there are no in- 
stances of a very high bacteria count or that the general 
average is good? I don't think in a big city like this that 
we can ever hope to find no single instance of high bac- 
terial count. If our general average is good it is certainly 
all that we can expect. 

Commissioner Hebberd: I vv'ould like to ask Dr. Bensel 
to v^^hat extent the milk sold in the shops is subjected to 
bacteriological tests? 

Df. BcnscI: We make tests all through the summer in 



BACTERIAL COUNT 67 

the shops, the railroad platforms, at the farms and at various 
other places. 

Commissioner Hebberd: I must confess that I have a 
little curiosity to know what the results are with relation 
to the milk taken from the shops in the poorer districts of 
the city after examination. What would you say the aver- 
age count was? 

Dr. Bensel: In the poorer districts it is very high. 

Commissioner Hebberd: What would it be? 

Dr, Bensel: Over a million very frequently; several 
million very frequently. You must remember that these in- 
spections in the country districts were practically begun in 
June. 

Dr. Williams: I would like to know on what bacterio- 
logical count milk sold in the shops and at the depot is con- 
demned ? 

Dr* Bensel: On bacterial count milk is not condemned. 
By the time the count is finished the milk is consumed. 

Dr. Williams: If a man is selling milk at a high count 
is he fined? 

Dr. Bensel: No ; but his source is followed up and the 
conditions at his creamery or the farm and the method of 
handling the milk are immediately corrected. 

Dr. Williams: Then there is no bacteriological count 
standard as yet? 

Dr. Bensel: Not as yet. 

A Voice: 500,000 is what they use in Boston to make 
prosecutions on. 

Mr. Allen: I would like to ask Dr. Bensel if, by say- 
ing that 14 inspectors for the city are enough, he has in 
mind the winter need for inspection or the summer need 
for inspection? If he thinks that 16 are a large enough 
number for our summer work? 

Dr. Bensel: Transportation in the city is so easy that 
we can throw our whole 14 inspectors in one day or one 



68 WINTER INSPECTION 

night in one place, and the next day in another place, and 
we can use them to such advantage that they are all we 
require now. Our crying need is the increase of country in- 
spectors. 

Pfofessof Pearson: I have always felt that winter in- 
spection was exceedingly important. I think the bacterio- 
logical examination of milk in winter shows that there is a 
larger proportion of objectionable germs in milk at that 
season than in the summer, for the reason that the cows are 
confined in barnyards and stables. In the summer season 
contamination is shown by the souring of the milk ; this is 
evidence of contamination. In winter milk may be worse 
contaminated and show nothing either by taste or smell. A 
great aid to inspection in summer is the simple acid test. 
In 30 seconds an official can inspect a can of milk and ascer- 
tain the amount of acid present and that will indicate to him 
whether the milk has been kept at a sufficiently low tempera- 
ture since it was drawn from the cow. 

What I think should be emphasized is the need of in- 
spectors who are well trained and familiar with country con- 
ditions. Sometimes, I know it to be a fact in connection 
with this city's supply as well as others, inspectors not 
famiHar with country conditions have found great fault 
with unimportant details and ignored or treated in some 
ridiculous way important features, both good and bad. I 
am not criticizing New York conditions alone. I want to 
congratulate Dr. Bensel and his assistant on the good work 
they are doing. Some time ago I visited a milk station and 
noticed as the farmers drove up that the manager spoke a 
few words in a low tone to each. I asked him what he was 
telling these people. He said, ''We heard the New York 
inspectors are down the line a little way and I was telling 
them they must brush up a little before the inspectors got 
here." (Laughter.) That is the moral efifect of inspection 
upon that district. Even if the inspectors never visited that 
town, the fact that they came within ten miles of it had a 
good eflFect. 

I think some benefit of inspection might be extended to 
every shipper of milk to this city in this way : Send out a 
blank form asking for specific information about the dairy. 



EDUCATION 69 

"How many cows have you? Is your barn tightly sealed? 
Have you a cement floor?" etc. Require them to fill out 
these forms. The fact that the farmer has filled out the 
blank can't help having a good effect, as it shows that he 
has thought of the essentials. 



In reply by mail to questions under "Inspection," seven- 
teen out of twenty-three expressed the opinion that it is 
IK>ssible to secure a clean milk supply by inspection, provided 
the inspection is conducted in the right manner, with quali- 
fications, such as "with some increase of price to the farmer," 
"with aid of legislative penalties," "with proper transporta- 
tion." Only four replied in the negative, and one of these 
added "though it aids greatly." 

The average frequency of inspection advocated was once 
every two months, with several suggestions that even closer 
visits might be needed in some cases at first. 

As to its protecting against the more dangerous forms 
of infection there was only one unqualified "No." Six 
gave an unqualified "Yes," the remainder varying qualified 
affirmatives, which may be summed up as saying that it is 
the only way to keep out of milk those deadly germs which 
the most thorough sterilization alone can destroy. 



The Chairman: We will reverse the 
Education. order of the next two subjects and take up 
education first. "Should State system of 
lectures before agricultural institutes be extended? Should 
the Maryland plan of travehng school be adopted as a 
means of reaching the producer? What can be done to 
assist the Teachers' College in its plan for a milk exhibit?" 

Dn Fttlton: In this very admirable summary here, the 
program, I find the greatest satisfaction in one little point 
that jars me slightly, and that is the question under this 
head, "Should the Maryland plan of traveling school be 
adopted as a means of reaching the producer?" I don't 
mind having that very excellent plan attributed to the 



70 EDUCATION IN COUNTRY 

State from which I come, but it is historically incorrect. 
What little I learned about the dairy inspector I learned 
from a New Yorker. It is a means of educating the farmer 
in many parts of the country and especially here in the 
North. We have had specialists in various subjects, es- 
pecially in agriculture, but you don't need to come to 
Maryland to learn about it. They are frequent in many 
States. 

Now, the points about the Dairy Special last spring 
are that the State Board of Health was planning a good 
series of popular lectures on various subjects connected 
with milk supply and intended at the end to give a milk 
exhibit which came ofif in May of last year. The Director 
of the Farmers' Institute at the same time had had his corn 
special and tobacco special and thought it a good plan 
to run a Dairy Special. 

The Dairy Special in Maryland did not cost anything 
as far as transportation was concerned. The railroads 
carrying milk were perfectly willing to put two cars and an 
engine and crew at the disposal of this group of men who 
ran the Dairy Special. The advertising cost some money. 
It was advertised in advance by posters which were pretty 
large, at all the stations. A careful itinerary is planned. 
The idea is to make as many stops as can be convenientlv 
made in a day's travel so that the stations on the road are 
checked ofif carefully so as to permit moving from one 
station to another in about eight or nine or fifteen minutes, 
and the farmers all are advised just at v/hat hour the train 
will arrive. The county newspapers announce this in 
advance. 

The train carries four people; ordinarily two are 
enough to speak. The idea is to spend just forty minutes 
at a station. One of the cars is used as an auditorium, 
and five minutes are allowed for the farmers to come in 
and fifteen minutes for each of the speakers and five 
minutes to get started in. I greatly admired Mr. Jared 
Van Wagenen's skill in speaking within five seconds of his 
allotted time. 

Now, great improvements are possible with this idea. 



TEACHERS COLLEGE EXHIBIT 71 

In addition to giving the farmers the reasons why we were 
out on the road and the special points they needed, we 
encouraged them to come down to Baltimore and see our 
milk show and go to the lectures there which were being 
held once a week. 

I think, however, that the dairy special could be elabor- 
ated and improved and made very profitable if it were com- 
bined with some kind of an objective exhibition of dairy 
methods. 

May I say just another word about the assistance that 
this conference can give to the Teachers College in this 
matter of a milk exhibit? I will not pretend to advise this 
conference except to commend this enterprise very 
strongly. There is one thing in which this conference can 
help the Teachers College, and that is a body of enthusi- 
astic men who are sufificiently trained to know on this sub- 
ject that they don't know very much about it. If they have 
gotten so far as that and will give the Teachers College 
the assistance necessary to enable them to give a great deal 
better exhibit than we gave down in Baltimore last May, 
I think it will help you to answ^er a great many questions 
that are asked in this excellent summary. 

The educational idea cannot be very well overworked 
in all these questions of social amelioration and sanitary 
improvement. Just by getting a small group of enthusi- 
astic people, whose knowledge is infectious, and spread 
that abroad, and you can do the last thing necessary for all 
of this sanitary work and sociological work. That, I think, 
is the whole matter. I very heartily commend the am- 
bition of the Teachers College to your assistance. 

Assistant Commissioneif Flanders: Jared Van Wag- 
enen, to whom the gentleman from Maryland has referred, 
is one of the Institute workers in the State of New York. 
These institutes are held under the auspices of the De- 
partment of Agriculture. During the past year there were 
270 such institutes held in the State with 1,096 dififerent 
sessions. They are held in different places in the State 
upon request. Some of them are for one day, others for 
two days, v/hile others are for three days, depending upon 
the needs of the localitv. 



72 EDUCATION OF FARMERS 

The Director of the Farmers' Institute informs me that 
he had calls for three or four times as many meetings as he 
was able to hold with the money at his command. Twenty 
thousand dollars was appropriated for this purpose by the 
Legislature. The first appropriation ever made for th^.s 
work was $5,000, then $10,000 for a number of years, then 
$15,000 and finally $20,000, which amount has been appro- 
priated annually for a number of years. With the great 
demand for these institutes it has been thought that more 
money should be appropriated for this work. 

The lectures delivered at these institutes are supposed 
to cover all the educational side of agriculture, and are for 
that reason schools for those who are employed upon the 
soil and unable to attend regular agricultural schools. 

You are discussing the milk question at this meeting, 
and I desire to impress you with the idea that a great work 
is being done at the institutes in disseminating knowledge 
relative to the production, care and transportation of milk. 
Somebody has said somewhere that if you would have tht: 
nation have a high standard you should commence by re- 
forming the individual; that you cannot make laws thai 
will govern the different classes of people in such a wav as 
to make them aggressively loyal. Applying this principle 
to the question at issue, I would suggest that it would be ;» 
pretty good thing to do to make the work thorough in edu- 
cating the fellow who produces the milk, so that he will 
know how to do that work in the best possible way. This 
can be done to a large extent by increasing the capacity 
of the institute work. At these meetings ali the questions 
are discussed by men who are experts, or at least as neat 
experts as we can procure. 



Dn Chapin: I notice one question, "Can nothing be 
done to increase the supply and cheapen the price of ice?" 
I think that is a very important subject. It is impossible 
to care for milk unless we can have plenty of ice available 
for the farm. 

In the preliminary work of the Milk Commission here, 
we found many small farms cooling their milk in springs, 
and we had the temperature of springs taken through New 



HOUSEHOLD EDUCATION 73 

York State and we found the temperature very much 
higher than we supposed and not low enough to properly 
cool the milk. No matter how careful the farmer was there 
would be a high bacterial count. 

A Member: I have often been impressed with the possi- 
bilities of increasing the storage of ice by the individual 
farmers. The question of producing a low temperature in 
the milk rapidly or cooling the milk down as Dr. Chapin 
has remarked, cannot be done with ordinary spring water. 
Now, every farm has a little pond on the place, and we 
should include in our recommendations the resolution as a 
result of this discussion, advice to the farmers to collect 
their own ice and use ice in cooling their milk and im- 
press upon them the importance of an early cooling of the 
milk to get it to a low temperature before they send it to 
the creamery. 

Professor Vultc: The object of this report is really to 
educate the consumer of New York in the methods we 
would use in the trade handling of the milk. Very largely 
that and also as to the treatment of milk in the household 
after they receive it. Now, the milk may be received at 
the household in a perfectly sanitary condition, yet after it 
is received there, from improper storage and handling it 
becomes absolutely unfit for food. That has come to the 
notice of almost everybody who has had anything to do 
with the household. Even in the best household, milk is 
not kept in an absolute sanitary condition. 

Look at the way milk is kept in the ordinary household 
in the refrigerator? What is the ordinary refrigerator ex- 
cept an incubator for germs? I have looked into that 
matter a good deal and I can speak authoritatively on that 
subject. 

Now, the Milk Exhibit would deal with the following 
subjects : first, the milk proper, which would include the 
cattle, dairy methods, creameries, dairy apparatus, dairy 
foods, etc. ; transportation, and, lastly, inspection. That 
would include the work of the Board of Health; bacteri- 
ological tests, analyses, etc., in the household; invalid food, 
etc.; second, dealing with the commercial products of 



74 EDUCATION IN TENEMENTS 

milk, leaving aside entirely those that were used for strictly 
commercial uses and not for actual food — that is, the con- 
densed milk, milk powders, malted and fermented milk and 
other special preparations. 

There is no question but what this is a large under- 
taking. This is a great city. The only question is whether 
we can interest the inhabitants enough here to carry it to 
a successful conclusion. We ask the aid of the Association 
and those present in making it successful. 

The Chairmanj Gentlemen, there are a number of 
very important questions that have not been touched upon. 
''What can be done to teach mothers to detect unclean 
milk and to care properly for milk purchased? How can 
tenement mothers keep milk at a proper temperature?" 

Pfofessor Pearson: I think they should be instructed 
to look for sediment. If they pick up a bottle too quickly 
the sediment will disappear. And the mother should be 
trained to consider the cleanliness of the store where they 
buy their milk. That goes back to the former subject. 
They should understand which stores are unsanitary. 

Dt* "Williams: There seems to be one possibility of 
educating the tenement mothers in utilizing a large number 
of recreation piers that we have in the city. It seems to me 
there is a possibility of using the end of the recreation piers 
as centers of instruction to the mothers about how to 
detect the bad milk and how to care for the milk in their 
homes. 

Df. Ager: In regard to the tenement house question, 
I have found that something could be done by advising 
several mothers in a tenement to combine on the ice ques- 
tion. Sometimes they feel they cannot have ice, but several 
families can combine, having one small ice box or rather a 
substitute for an ice box and one good-sized piece of ice, 
and then the milk supplied to three or four families kept in 
that. It is a small volume of milk. I haven't meant, of 
course, the milk from the distributing stations for the feed- 
ing of children. 



education: permanent committee 75 

In reply to some of the questions under ''Education" 
there came by mail a general statement that State Agricul- 
tural Institute lectures should be extended and the traveling 
school adopted for the education of the producer. 

To teach mothers and to bring the consumer generally 
to a proper appreciation of the value of pure milk as a food 
and methods of caring for it, many suggestions were made 
of infants' milk depots with nurses and physicians in 
charge ; model milk shops with a constant lesson in their evi- 
dent cleanliness ; free illustrated lectures in schools, churches, 
and through other societies ; teaching in public and private 
schools ; circulation of attractive leaflets and circulars in 
different languages through schools, libraries, settlements 
and churches. 



The Chairman: The last question under this head is, 
"Is it desirable that a local committee be formed to co- 
operate with the Department of Health and County Med- 
ical Society?" 



Mr. Freeman: I believe that this conference is the most 
important meeting in connection with our milk supply that 
we have ever had m New York. I feel that all the gentle- 
men who have taken part have felt that this is true. It 
seems to me that a committee should be appointed to con- 
tinue this work and I move, Mr. Chairman, that such a 
committee be appointed by your Association ; there should 
be a general committee and a smaller executive committee. 



Motion duly seconded and carried that a committee be 

appointed by the New York Association for Improving 
the Condition of the Poor to co-operate with the Depart- 
ment of Health and the County Medical Society with re- 
gard to the subjects that have been discussed at this con- 
ference, there being one large committee and an executive 
committee. 



76 LEGISLATION 

The Chairman: We come now to the 
Legitlation. broad subject of legislation. Are there any 
remarks to be made upon these various 
questions ? 

Dr, Bensel: With regard to the transfer from one 
can to another, or from a can to a bottle on the open street, 
being made a misdemeanor, at present it is a misdemeanor 
to transfer milk from a can to a bottle or from one to an- 
other, except to the vessel of the purchaser. From the can 
to the vessel of the purchaser, but in no other way. so that 
is covered by the present law. 

''Shall pollution of milk cans and bottles be made a mis- 
demeanor?" I feel that is of very great importance. We 
have touched on it to some extent, but it seems to me not 
in the right way. There is no possible solution of that until 
the city provides a city ordinance which makes it a misde- 
meanor to have a dirty, filthy bottle in your possession. 
That will make anybody who has anything to do with milk 
bottles clean them up as soon as the milk is out of them. 

The Chairman: I would like to ask Dr. Bensel if he 
regards, aside from that, the present sanitary code suffi- 
cient and adequate? 

Dr, Bensel: Yes. 

The Chairman: There is also this question to be con- 
sidered: "Shall sealing cans at creameries be required?" 

A Member: I think we should all agree that they should 
be sealed. 

The Chairman: "Should a bacterial standard be es- 
tablished ?" 

Commissioner Greene: I am not a bacteriologist, but 
locally where I live this scheme works to perfection. The 
farmer who sends in a milk containing 1,500,000 bacteria is 
written to and told his milk will be stopped unless it is 
brought down below 500,000, and I haven't known a case 
where it didn't come down within a week. We have pol- 
luted milk bottles in possession a misdemeanor, and that 
is working to perfection. We have had to prosecute a few 



LEGISLATION 77 



cases, but the papers show that up and it becomes public 
property and we have very little trouble. It has a good 
effect upon the farmers in bringing the milk into the city 
properly cooled and in a clean condition. 



Dr. Park: As to the legal standard of bacteria, so far 
as I know, the first attempt to make such a standard was 
established by the New York City Board of Health in 1900. 
We believed it to be unnecessary for any milk in New York 
City to contain over one million bacteria. We therefore 
sent notes to the farms and dealers whose milk contained 
over that number, telling them that their milk was too old, 
or too dirty, or kept too warm. This was so indefinite that 
we decided to return to inspection of conditions. In the 
first place, it is almost im.possible for a farmer to be sure of 
delivering any given can in sum.mer which will not run over 
a million bacteria per c.c. So many individuals have to deal 
with the milk between the farm and the consumer that it is 
very hard to fix responsibility, and it is unquestionably 
true that pretty fair milk 48 hours old, if not properly cared 
for by the railroad or by the dealer, may run over one 
million bacteria. While, therefore, it is not necessary in one 
sense to have any such milk, yet as a matter of fact there 
being so many persons dealing with it, a considerable por- 
tion of the milk in summer will have such an excess of 
bacteria. Even under the very best conditions, such a num- 
ber of bacteria will occasionally be present. It is impossi- 
ble, therefore, to actually enforce a legal standard, for the 
number of bacteria which will condemn milk in a large city 
without making it too high to be useful. 

In Boston, copying the New York suggestion, but going 
further and making it a legal standard, it is true that two 
cases have been tested in the courts by the Health Depart- 
ment in two years, but everyone knows that there have been 
many thousand violations. In smaller cities a bacterial 
standard might be enforced with advantage, but here the 
publication of the average counts of the different dealers 
would, in my opinion, be a much safer method of dealing 
with the question. 



78 LEGISLATION 

Dr. Golef: I believe thoroughly in the bacterial stand- 
ard for municipal milk supplies, but it doesn't seem to me 
that New York City is ready to establish a bacterial stand- 
ard now. I believe it will improve its milk supply by in- 
spection and then get the standard, but if you follow the 
footsteps of Boston and get a standard of 500,000 and then 
don't enforce it, you only do yourselves harm and harm to 
every city that is trying to establish a standard. 

We are attempting to get 100,000 and have been for 
years, and we don't get now 7 per cent, in 1,100 samples 
that contain more than 500,000, but if you establish a bac- 
terial standard of high count it will not do you much good 
and you will do every other smaller city very much harm. 

There is one thing in connection with the bacterial standard 
that is very important, and that is that we haven't paid 
enough attention to the milk can and if New York City or 
any other city could establish a plan whereby it could in- 
sist by force of law, if necessary, that it should be a misde- 
meanor for a man to have a dirty milk can or bottle, or to 
send it out on the railroad, it would be a very good thing. 
It would tend to materially diminish the large counts in 
milk. It is due to the dirty can and the dirty dairy. If you 
can wipe those out you will do a great deal for your milk 
supply. 



In fcply to inquiry by mail in regard to questiona raised 
in program under "Legislation," to which so little time 
could be given at the conference on account of the lateness 
of the hour, answers were received, of which a summary 
follows : 

As to diseased cattle, the following recommendations: 
"Tuberculous cattle should be destroyed" ; "regular inspec- 
tion of herds by qualified veterinarians" ; "cattle with incur- 
able diseases to be killed" ; "veterinary inspector's certificate 
twice yearly, including tuberculin test, to be produced when 
called for by inspector"; "some provision to pay for con- 
demned cases of tuberculosis" ; "no cattle with diseased ud- 



LEGISLATION 79 

ders may be allowed" ; "sufficient appropriations to enforce 
existing laws" ; "requiring efficient inspection and tuberculin 
test" ; "making tuberculin test necessary for all dairy cattle" ; 
"milk from diseased cattle should be classed as adulterated 
and its sale prohibited"; "proper inspection and destruction 
of diseased cattle" ; "dependent upon nature of disease, some 
cows should be killed, others quarantined and the milk de- 
stroyed" ; "appropriation for inspection and tuberculin in- 
oculation" ; "confiscation of all such cattle and disposal by 
public authorities" ; "cows should not be admitted to the 
State without passing test for tuberculosis and after a cer- 
tain date milk from tuberculin reacting cattle should be ex- 
cluded" ; "more frequent and comprehensive examination — 
in fact, larger appropriations" ; "tuberculin test and exclu- 
sion of 'reacting' cows" ; "cattle should be tested for tuber- 
culosis before coming into our State." 

As to persons producing or handling milk, there was ?. 
unanimous expression of belief that milk should not be sent 
to market from a dairy where any person living or employed 
on or about the premises has a contagious or infectious 
disease, and that the same strict rule should apply to all per- 
sons and premises where milk is in any way handled in the 
country or city. Any violation of this rule should be made 
a misdemeanor. 

As to the sterilization of milk cans and bottles being re- 
quired by law, there were different ways of expressing the 
same general opinion that all milk containers should be first 
thoroughly cleansed by some efficient means as soon as 
emptied, and that such cleansing should be required of all 
dealers so that they shall be clean when shipped back to 
the country and that they shall be sterilized immediately be- 
fore being refilled, by the person or creamery doing the re- 
filling. Sterilization kills germs but does not cleanse or 
remove dirt. 

As to sealing cans at creameries, nearly all thought it 
desirable, but Dr. Bensel pointed out its "extreme inad- 
visability," because it would tend to furnish the retail dealer 
whom they can prosecute here in the city for adulteration 
with a reference back to the creamery, which is beyond the 



80 LEGISLATION 

Health Department's reach for prosecution. A seal is a 
good protection as between a dealer and a creamery under 
contract with each other, but as a matter of administration 
would be a mistake as to the general milk supply. 

In regard to the pollution of milk cans and bottles there 
was a hearty response that it should be made a misdemeanor. 

As to a bacterial standard, there were eight favorable 
and eight opposed, with four considering it desirable when 
practicable. 

State supervision was considered very inadequate, which 
was thought in great measure chargeable to lack of State 
appropriations. Strong efforts should be made to secure 
State cooperation. 

What further legislation? "Bring the State and city laws 
into harmony. Repeal the State law which permits the sale 
of milk under standard if produced by cows, which en- 
courages the use of cows which produce large quantities of 
milk under standard and interferes with the enforcement of 
regulations requiring standard milk. 

Dn Park: We have practically left the question of dis- 
eased cattle out of the discussion. Would it not be well to 
make some reference to the fact that we have left it out be- 
cause it is too big a subject to handle? 

Commissioner Hebberd: The Department of Agricul- 
ture had $25,000 appropriated last year by the Legislature 
to look after diseases in domestic animals, among those 
tuberculosis. A report handed to me a few days ago showed 
that about 1,400 head of suspected cattle during the last 
year were examined, and out of that number in the neigh- 
borhood of 500 had been condemned. 

Now, it is believed by some people that that is not money 
enough to do this work. It is a subject worthy of your 
consideration. For my part, I believe the State ought to 
do a great deal more than it is doing at the present time 
with respect to this matter. T don't agree quite with Dr. 
Bensd that the city ought to do all the work, although the 
State is doing excellent work under the Department of 
Health at present, as I personally know. 



LEGISLATION 81 

The Chairman: Gentlemen, the hour is getting late. 
We have not had time with the discussion running along 
to formulate any agreement under the last three heads that 
have been discussed. Is there any motion or any sugges- 
tion to be made with respect to that and with respect gen- 
erally to the work of the conference to-day? 

Df, Holt: It seems to me of the utmost importance that 
the work of this conference should be gathered up and put 
in a proper shape for reference and for publication, and to 
that end I move that a committee be appointed by the Chair 
to take up this end of the work and to act upon it. Unless 
some step of this kind is taken, a large amount of the valu- 
able material which has come out in this discussion is likely 
to be lost. There are questions here which interest not only 
those who are in this room, but a very large number outside, 
a great many of whom would have attended the conference 
if circumstances had permitted. 

Motion that a committee of five be appointed by the 
Chair to edit and publish the work of this conference duly 
seconded and carried. 

The Chairman appointed as this committee, Dr. Rowland 
G. Freeman, Dr. L. Emmett Holt, Ernst J. Lederle, Ph.D., 
Dr. Linsly R. Williams and Mr. J. E. Sayles. 

Motion that the permanent committee to be appointed to 
cooperate with the Departmnt of Health and County Medi- 
cal Society, also cooperate with the Teachers College in its 
plan for a milk exhibit, duly seconded and carried. 

The conference then adjourned sine die. 



SUMMARY BY COMMITTEE ON REPORT- 

The committee appointed to revise, edit and publish a 
report of the conference, presents the foregoing copy of its 
proceedings. 

The magnitude of the subject and the short time of 
meeting prevented the formulation and submission at the 
close of resolutions covering the important topics "inspec- 



82 SUMMARY 

tion," "education" and "legislation." Brief answers by mail 
to questions under these headings and in regard to compul- 
sory and commercial pasteurization were asked for and fur- 
nished by members, and are given above. 

The committee has been requested to present a summary 
indicating the most important conclusions, and suggesting 
first lines of action. 

Inspection of dairies and creameries was, without doubt, 
regarded as of the first importance. 

To accomplish this with reasonable speed and thor- 
oughness sixty to eighty inspectors in the country are 
needed. The milk must be drawn from healthy cows 
under conditions of cleanliness of animals, milkmen, 
premises, water, utensils and milk cans ; must be imme- 
diately cooled to at least 50° F., and so delivered at 
creameries, where it should be handled in a thoroughly 
sanitary manner and further cooled. Inspection must 
then follow it every step of the way to the consumer, 
protecting it from contamination and never permitting 
its temperature to rise at any stage above 50° F. 

The expression was unanimous that nothing can 
render such inspection unnecessary or reduce its im- 
portance. 

Equally important is it that all cans and bottles shall 
be cleansed immediately after being emptied and so 
sent back clean to the country, where they should be 
sterilized before being refilled. Closely allied to this is 
the necessity for improved cans which can be more 
easily cleaned. 

The improvement of conditions in retail stores, while in 
a great measure covered by "inspection," involves much be- 
sides, such as 

New regulations as to construction and handling 
and conditions in stores, all tending to the final estab- 
lishment of model milk shops. 

Infants milk depots are at once of the most vital im- 
portance being directly related to infant mortality, and 
within the possibility of early establishment. 

To secure the cleanliness of the vast total milk sup- 



SUMMARY 83 

ply and its proper distribution is a tremendous task ; to 
obtain 10,000 quarts daily of clean milk and place it 
within the reach of the people, .pasteurized or raw, 
modified, in feeding bottles, with directions from physi- 
cians and nurses, as indicated in the report, is no small 
undertaking, but is within the power of more than one 
single philanthropist in this city to render possible 
within a few months. 

Education. — To secure anything approaching the best 
results to follow such inspection, improvement in shops and 
establishment of infants' milk depots, the education of the 
people must go forward. 

They must be taught the value of milk as a food 
and the absolute need of cleanliness of handling after it 
comes into their hands. 

Every social, educational and philanthropic agency 
in this city should lend its best aid to intelligent efforts 
in this direction. 

Legislation* — To render possible the accomplishment of 
these ends regulations and legislation must be secured, city. 
State and Federal. 

A constant and unceasing: pressure along all these lines, 
backed by an enlightened public opinion, is necessary to per- 
manent reform. 

Rowland G. Freeman, 

Chairman. . . 
John E. Sayles, 

Secretary. 
Committee on Report: 

Rowland G. Freeman, M. D., 

Chairman, 
L. Emmett Holt, M. D., 
Ernst J. Lederle, Ph. D. 
LiNSLY R. Williams, M. D., 
John E. Sayles. 



LETTER FROM PROF. LEONARD PEARSON. 

University of Pennsylvania, 
Department of Veterinary Medicine. 
Office of the Dean, Leonard Pearson. 

PhiLxVdelphia, November 14, 1906. 
Mr. George W. Wickersham, 

Chairman Milk Conference Committee, 
105 East 22d Street, New York : 

Dear Sir — In reply to your recent letter, inviting me to 
attend a conference that is to be held in New York City to 
consider questions relating to the milk supply, I regret to 
have to say that I cannot be present because I am starting 
to-morrow for the West. 

The subject that you are to discuss is one in which I 
am deeply interested, and if you have a later conference on 
the subject, and if I can be of any assistance, I hope that 
you will not hesitate to call upon me. 

I am convinced that satisfactory milk cannot be secured 
without some oversight at the seat of production — that is, 
inspection of herds and farms. Inspectors to do this work 
well should be very carefully selected ; they should be skilled 
in regard to the diseases of animals and in regard to dairy 
husbandry; they should have a working knowledge of the 
fundamental principles of sanitary science, and should know 
the significance of the teachings of bacteriology. There 
should be on this force of inspectors a number of com- 
petent, well-trained veterinarians and men trained in good 
schools of dairying. 

There are advantages, and there are decided disadvan- 
tages, in pasteurization. If milk is sold as pasteurized it 
should be rigidly required that it shall have been heated to 
a point that will insure the destruction of pathogenic or- 
ganisms. It will be well to require that the milk shall have 
been heated to 80 degrees C. (176 degrees F.), because it 
can be determined, by a simple chemical test, whether this 
temperature has been reached or not, and, therefore, whether 
the pasteurization has been practiced, as claimed. Further- 
more, all packages containing pasteurized milk should in 
some way be distinctly and clearly marked with a label giv- 



;o? 



86 LETTER FROM PROF. LEONARD PEARSON 

ing the date and method (time and temperature) of pas- 
teurization. As pasteurized milk often spoils without sour- 
ing, the consumer does not have the usual internal evidence 
of staleness, and is thereby likely to be misled, and possibly 
injured, by deteriorated pasteurized milk. 

I am very strongly of the opinion that the sale of 
skimmed milk should be permitted. It is idle to think that 
New York City cannot control the sale of skimmed milk 
and prevent its fraudulent sale, as has been done by other 
cities in all civilized countries. It might be necessary to 
appoint a few more milk inspectors and it might be neces- 
sary, by legislation, to provide severe penalties for all deal- 
ers in milk who have in their possession, in shops or wagons, 
skimmed milk that is not in a characteristically and conspicu- 
ously marked container. Having skimmed milk in any 
other sort of container than that prescribed by law should 
be regarded as prima facie evidence of attempt to defraud, 
and should subject the dealer to penalty. It would be far 
better for the city to appoint a few extra inspectors, if nec- 
essary, than for the poor of New York to be deprived of 
this very excellent and cheap food. 

In conclusion, I would say again, that the protection of 
milk from contamination at the source is the next important 
step to be taken in milk control. The supervision of the 
milk supply under existing laws has served to eliminate to 
a very large extent the formerly prevalent practice of partly 
skimming, watering, coloring and preserving milk, and, so 
long as the present milk inspection is continued, danger 
from these practices may be regarded as small. Milk is 
dangerous because it is permitted to be polluted and infected. 
It is for the prevention of these contaminations that inspec- 
tion at the source is urgently needed. 

I trust that you will be very successful in your important 
work. Sincerely yours, 

Leonard Pearson. 



A. I. C. P.: Epochs of Advance 



Organization. 1845 Improved housing studies 

Distribution, among capitaHsts and builders, of plans for 

model tenements 
Projection N. Y. Juvenile Asylum, and founding of DeMilt 

dispensary 
Founding of the Northwestern Dispensary 

A public washing and bathing establishment, built at a cost 
of $42,000 
A social, moral, statistical census of certain sections of New 

York City 
Special investigations regarding cellar residences, defective 

dwellings, sewerage and filthy streets 
Popular public lectures on hygiene and sanitation. 
Founding of the Society for the relief of the Ruptured and 

Crippled 
Legislation preventing adulteration and traffic in impure milk 
Special sanitary measures to counteract the cholera epidemic 
Absorption into homes of 10,000 soldiers and sailors disabled 

in the war 
Projection of improvements in city market, wharves, and 

piers, which menaced public health by defective sewerage 
A ODmmittee of Public Hygiene cooperating with the Board 

of Health in tenement house inspection 
Opening of a Sewing Bureau for employment of women at 

their homes 
Ocean parties to West Coney Island 
People's Baths, 9 Center Market Place, built at a cost of 

$28,000 
Vacation Schools started. Six in 1895 and 1896, ten in 1897 
Cultivation of vacant lots by the unemployed 
Formation of the Improved Housing Council, which organ- 
ized The City and Suburban Homes Company (capitalized 

at $1,000,000) 
Appropriation by the city of funds to build three public baths 

in the Borough of Manhattan through the efforts of this 

association 
Lx)nger Fresh Air Season ; 20 weeks instead of 8 
Opening People's Baths, Milbank Memorial, 325-327 East 38th 

street 

Seaside Tent Camp. First American experiment in salt air 
treatment of little children suffering from Non-Pulmo- 
nary forms of Tuberculosis 

Visiting Cleaners added to relief staff 
Report on defective records and accounts. New York Public 

Schools. Initiative leading to Conference on Hospital 

Needs and Hospital Finances 
Committee on Physical Welfare of School Children organ- 
ized; Agitation resulting in School Census; Pure Milk 

Crusade; Junior Sea Breeze, Open Air Camp for Sick 

Babies ; Fund of $250,000 .raised for a Permanent Sea Side 

Hospital 



LIBRARY OF CONGRESS 



000 896 072 • 

New York Milk Committee 

George W. Wickersham, Cliairman 
John E. Sayles, Secretary 



EXECUTIVE COMMITTEE 
LiNSLY R. Williams, M. D., Chairman 
Haven Emerson, M. D. Charles T. Root 

Rowland G. Freeman, M. D. DeWitt J. Seligman 

Arthur M. Harris Stephen G. Williams 

John E. Sayles, Secretary 



Ernest Hamlin Abbott 

William H. Allen 

Hugh D. Auchincloss 

E. H. Hartley, M. D., 

Pres. Nicholas Murray Butler 

R. Fulton Cutting 

Richard Harding Davis 

Haven Emerson, M. D. 

Simon Flexner, M. D. 

Rowland G. Freeman, M, D. 

Joseph N. Francolini 

Rt. Rev. David H. Greer 

Arthur M. Harris 

E. Eltot Harris, M. D. 

Frederick Trevor Hill 

L. Emmett Holt, M. D. 

Edward F. Hurd, M. D. 

John S. Huyler 

Ernst J. Lederle, Ph. D. 



A. J. MiLBANK 

Cleveland Moffett 
Robert C. Ogden 
Percy R. Pyne 
Joseph H. Raymond, M. D. 
Jacob A. Riis 
Charles T. Root 
John E. Sayles 
DeWitt J. Seligman 
Mortimer L. Schiff 
Samuel Sloan, Jr. 
Theodore B. Starr 
Nathan Straus 
E. H. Van Ingen 
Prof. H. T. Vulte 
Rev. William J. White 
George W. Wickersham 
LiNSLY R. Williams, M. D. 
Stephen G. Williams 



LIBRARY OF CONGRESS 



DDDDfl^bD72D 



